site.btaBudget Committee Approves at First Reading 2026 National Health Insurance Fund Bill

Parliament’s Budget and Finance Committee Tuesday approved at first reading the 2026 draft budget of the National Health Insurance Fund (NHIF). Thirteen MPs voted in favour, eight against, and none abstained.

Confederation of Independent Trade Unions in Bulgaria (CITUB) chief economist Lyuboslav Kostov said the union did not support the NHIF budget either in the Supervisory Board or in the National Council for Tripartite Cooperation. Their main concern is the EUR 260 million allocated through increased clinical pathway prices: "There is no guarantee these funds will go to wages, and the mechanism for financing salaries remains unclear," he said, adding that this also undermines collective bargaining and the forthcoming EU directive transposition. According to him, the EUR 260 million cannot realistically ensure wage growth, nor does it support collective bargaining.

Rumen Radev, Chair of the Bulgarian Industrial Capital Association, noted that all four nationally representative employer organizations have rejected the NHIF budget. The main reason, he said, is the lack of any change in the budget philosophy and the preservation of the same spending structure. Employers consider this approach entirely wrong. They also criticize the continued practice of allocating 75% of expenditures to hospital care and medicines, compared to 45–55% in other EU countries.

He added that hospital care remains excessively concentrated, 50% of funding is absorbed by the Sofia and Plovdiv regional funds, and that opportunities to optimize medicine costs, such as through centralized electronic tenders for oncology drugs, are not being used. On preventive care, he noted that coverage remains around 50% despite attempts at incentives, and stressed that prevention must be systematically expanded.