Congress is preparing a reform to contain increases in major medical expense insurance, after some policyholders have faced annual increases of up to 80%, in a context where medical inflation in the country has exceeded 14%, according to PRI lawmaker Jericó Abramo Masso, the main promoter of the proposal.
The initiative was introduced during the first months of 2026 and practically has the consensus needed for approval.
The proposal includes the regulation of private hospitals and seeks to cap annual increases in insurance policies and prevent increases of between 20% and 80%, in addition to containing medical inflation in Mexico, which has reached levels of 14.5%.
Among its main objectives, it would require private hospitals to publish their service rates every year, with the aim of making costs more transparent, encouraging competition, and reducing increases in policy prices.
Likewise, the initiative sets the goal of keeping medical inflation below 8% annually. In Mexico, this indicator has reached levels of 14.5%.
The proposal also seeks to protect older adults by eliminating VAT on their major medical expense insurance policies and establishing an income tax (ISR) exemption for people over 60.
It would also prevent increases in premiums from forcing this segment of the population out of the system and establish insurance portability so that users can switch insurance companies without losing seniority, completed waiting periods, or acquired rights.
At the same time, contracts would have to be clearer, and advice would have to be provided by certified agents.
They seek to curb abuses by insurance companies
During the first Extraordinary Meeting of the Finance and Public Credit Commission held this Wednesday, lawmaker Jericó Abramo Masso denounced various abuses by private hospitals and insurance companies that, he said, justify his initiative.
Regarding the lack of transparency in hospital rates, the legislator highlighted the complete absence of regulation over hospital costs and how this translates into arbitrary charges for users.
“The costs of hospitals in Mexico are in no way subject to any type of supervision. Although there is already an area in the Economic Law that says they have to submit their annual rates, they do not do so, and this has generated a lack of transparency between the presentation of expenses by a private hospital and the quotation made by a medical expense insurance company. There cannot be clarity in the rates for users, and at the end of the day, the user is left at the very end of the line,” he said.
He also criticized the refusal of almost all medical centers to provide clarity regarding bills while patients are hospitalized.
“Today you go to a hospital with an intermediate-care issue and spend three days in the process. If on the second day you request a statement of account, 96% of hospitals do not provide it. They tell you that they will give you a reference statement or an account statement once you leave,” he said.
Regarding medical inflation generated by the sector itself, Jericó Abramo Masso emphasized that the rising cost of private healthcare in the country is intentional and does not respond to external macroeconomic factors.
“Stopping medical inflation, which is the highest in the entire Northern Hemisphere, from Canada to Patagonia. Mexico is the country where medical inflation generated by the sector itself rises the most. It is not a matter of prices, it is not a matter of technology, it is something generated by hospitals. Only in Mexico is it self-generated to benefit the sector, leaving users far behind,” he added.
The legislator’s strongest criticism focused on how insurance companies took advantage of a four-month legislative extension to drastically increase their prices.
“The ruling was going to be voted on April 28. The insurance sector asked for more time. May, June, July, and August were already given to them, and the party is over. There is no excuse anymore; they cannot keep kicking the ball down the road. And the most unfortunate thing is that during those four months they continued increasing their premiums by up to 80%, taking it out on users. We are not going to allow this anymore,” he added.
Insurance companies call for joint solutions
Regarding the issue, the Mexican Association of Insurance Institutions (AMIS) said it has maintained an open and constructive dialogue with lawmakers from the different parliamentary groups in the Chamber of Deputies, with the aim of finding solutions that expand access to healthcare protection and strengthen policyholders’ rights.
“Healthcare is a complex ecosystem in which insurers, hospitals, doctors, medication providers, medical-device and medical-supply companies, authorities, and, at the center of all of them, patients participate. Therefore, solutions must be built with the participation of everyone, based on information, transparency, and technical criteria,” AMIS said.
It emphasized that it will continue working with Congress, authorities, and the various participants in the private healthcare system to promote solutions that protect users while preserving access to quality healthcare services and the sustainability of coverage.
Source: expansion
