Astana, 23 October. Under the 2027–2029 socio-economic forecast approved by the government in August, the Social Health Insurance Fund's spending in 2028 will reach 2,874.5bn tenge against revenue of 2,750.6bn, leaving the fund 123.9bn tenge in the red for the first time in the forecast period, Inbusiness.kz calculated.
Revenue in 2027 is expected at 2,584.5bn tenge and spending at 2,567.1bn, a surplus of 17.4bn. In 2029 spending will again exceed revenue, by 10.3bn tenge. A year ago the 2028 forecast was positive, +54.8bn tenge, so the estimate has worsened by 178.7bn. Financier and QazExpertClub expert Venera Zhanalina explains that an annual deficit does not mean the fund will stop paying clinics: the gap can be covered by accumulated reserves. "If spending on medical care systematically grows faster than revenue, this may lead to the accumulation of financial imbalances and a need for additional sources of funding," she said. Among the risks she names rising prices of medicines and technologies, higher pay for medical staff, growing demand for treatment and a wider list of covered services.
Measures to raise revenue have already been taken. Since 2026 the contribution cap has been raised to 20 minimum wages for employees and 40 for employers, with rates unchanged at 2% and 3%; according to state bodies, this will bring in about 200bn tenge a year. From 2027 the state's contribution rate for preferential categories will rise gradually from 2% to 4.7% by 2037. According to the Health Ministry, of about 16.7 million insured people in 2025, about 12.1 million belong to preferential categories for whom the state pays.
What it means: Compulsory health insurance may start spending more than it collects in two years. The deficit is still only a forecast and could be covered by reserves; the question is how fast spending grows.
Who benefits: The sources do not name beneficiaries. Patients, clinics paid by the fund and contributors depend on its balance; according to the expert, contributors would have to pay more if the imbalance became permanent.
Background: According to official data for 2024, about 1.25 trillion tenge in contributions went into the system: 42.3% from employers, 27.7% from employees and 23.1% from the state.
List of sources used: Inbusiness.kz
Artificial intelligence was used in preparing this material.
