Transfer CNOPS-CNSS: The CESE Issues a Warning
The Economic, Social, and Environmental Council (CESE) has raised serious concerns about the planned transfer of management for mandatory public health insurance from the CNOPS to the CNSS, as outlined in Law 54.23.
In its advisory opinion, the institution states that while this reform is significant for the expansion of social protection, it remains incomplete and poses several risks that could undermine the stability of the system. The CESE specifically highlights the lack of a prior actuarial study, which is essential for assessing the actual impact of this merger.
The council draws attention to the financial disparity between the two regimes: the CNSS reports a strong annual surplus and comfortable reserves, while the CNOPS has been grappling with a structural deficit that has worsened over the years. According to its projections, the public regime’s reserves could be depleted by 2028.
Moreover, the CESE warns of the danger of an automatic transfer of this deficit to the CNSS without prior corrective mechanisms in place. It cautions against excessive centralization of decision-making powers within the CNSS, which could weaken governance and complicate the institutional transition.
The integration of CNOPS employees into the CNSS presents another major challenge. Although their acquired rights will be preserved, the council points out potential difficulties related to the harmonization of careers and risks of losing expertise in public sector management.
Additionally, the CESE notes several legal ambiguities, particularly concerning the transitional period related to collective insurance contracts, as the cessation deadlines remain unspecified. This uncertainty creates confusion for the companies and stakeholders involved.
Finally, the elimination of the specific health insurance regime for students raises further concerns. Now attached to their parents’ coverage, some students may lose previously acquired benefits and face increased out-of-pocket medical expenses.
Despite these reservations, the CESE acknowledges some positive aspects of the reform, such as the digitization of medical records, the strengthening of negotiation power for the CNSS, and the acceleration of health system modernization.
