Premium relief initiative

What is the premium relief initiative?

The premium relief initiative, officially the popular initiative “Maximum 10% of income for health insurance premiums (Premium Relief Initiative)”, was a federal popular initiative launched by the Social Democratic Party (SP). It was submitted in January 2020 and called for insured persons to pay at most 10% of their disposable income for basic health insurance premiums. The Confederation and the cantons would have had to cover anything above that through premium subsidies, with the Confederation paying at least two thirds.

The Federal Council and Parliament rejected the initiative because, in their view, it was too expensive and created no incentive to curb healthcare costs. The FOPH estimated the additional annual expenditure for the Confederation and the cantons at 3.5 to 5 billion francs. On 09.06.2024 the people and the cantons rejected the initiative with 55.47% voting no.

Instead, an indirect counter-proposal came into force. It amends the Health Insurance Act (KVG) and, since 01.01.2026, has obliged every canton to spend a minimum amount on premium subsidies. When people talk about “premium relief” today, they often mean this counter-proposal.

The cost brake initiative was put to the vote on the same day. It focused on healthcare costs, not on the premium burden of individual insured persons.

How it works

Premium subsidies are financed jointly by the Confederation and the cantons. For years, the Confederation has paid a fixed contribution of 7.5% of the gross costs of basic health insurance. What is new is that every canton must also spend a minimum share. The counter-proposal works in three steps:

1. Measuring the burden: for each canton, it is calculated what share of income premiums account for on average among the 40% of insured persons with the lowest incomes. The basis is taxable income for direct federal tax and the premiums actually paid across all forms of insurance.
2. Deriving the minimum share: if the burden is below 11%, the canton must spend at least 3.5% of the gross costs of basic health insurance for its residents on premium subsidies. If it is 18.5% or more, the figure is at least 7.5%. In between, the minimum share rises linearly.
3. Setting the social target: every canton must determine the maximum share of disposable income that premiums may account for. The law does not specify a figure. If a canton has not done so four years after entry into force, the Federal Council sets the share.

For the transition, the following applies: in the first two calendar years, i.e. 2026 and 2027, the minimum share is 3.5% in all cantons. The graduated calculation only takes effect after that.

The canton decides who benefits from the additional funds. It can pay higher contributions to people who already receive premium subsidies, raise the income limits, or both. The counter-proposal does not give you any entitlement to a specific amount.

Legal basis

The initiative would have amended the Federal Constitution. Because it was rejected, only the counter-proposal applies, an amendment to the KVG of 29.09.2023, in force since 01.01.2026:

• Art. 65 para. 1ter KVG: each canton sets the maximum share of disposable income that premiums may account for among insured persons resident in the canton.
• Art. 65 para. 1quater KVG: the canton’s premium subsidies must correspond, per calendar year, to a minimum share of the gross costs of basic health insurance for its residents.
• Art. 65 para. 1quinquies KVG: the minimum share depends on the premium burden of the 40% of insured persons with the lowest incomes: below 11%, 3.5% applies; from 18.5%, 7.5% applies; in between, linearly.
• Art. 65 para. 1sexies and 1septies KVG: the basis of calculation (taxable income, average premium) and which expenditure is counted. Not counted are the assumption of certificates of unpaid debt under Art. 64a para. 4 KVG and the share of the federal contribution.
• Art. 66 para. 2 KVG: the federal contribution is 7.5% of the gross costs of basic health insurance.
• Transitional provision to the amendment of 29.09.2023: in the first two calendar years, a minimum share of 3.5% applies in all cantons; if a canton does not set its social target within four years, the Federal Council does so.

The details are governed by the Ordinance on the Contributions of the Cantons and the Confederation to Premium Subsidies (VPVK), which the Federal Council adopted on 12.09.2025. Even before that, Art. 65 para. 1bis KVG required the cantons to reduce the premiums of children from households with low and middle incomes by at least 80% and those of young adults in education by at least 50%.

Example: what the 10% limit would have meant and what applies now

The initiative: Lara, 36, lives in the city of Bern and pays the median premium of all offers for basic health insurance with a CHF 300 deductible: CHF 609.30 a month, i.e. CHF 7,311.60 a year (premiums 2026, municipality of Bern, region 1, adults, with accident cover; source FOPH). Under the initiative she would have been entitled to a subsidy as soon as her disposable income was below CHF 73,116, because 10% of that is CHF 7,311.60. How disposable income is calculated and which premium is decisive would still have had to be set by Parliament.

The counter-proposal: it does not affect Lara directly but the cantonal budget. The table shows the statutory minimum share for different burdens on the 40% of insured persons with the lowest incomes (from 2028; in 2026 and 2027, 3.5% applies everywhere).

What this means for you

What counts for you is not the initiative but the law of your canton of residence. The most important steps:

• Check your entitlement: whether and how much premium subsidy you receive depends on your income, your assets and your family situation. You will find your canton’s rules and deadlines under premium subsidies. Pay attention to how your canton calculates relevant income.
• Look again every year: cantons that have to spend more money can adjust their limits. If you only just missed out on an entitlement before, check the rules every year.
• Lower your premium: regardless of the subsidy, you can influence your premium through your choice of insurer, deductible and model. The premium calculator shows all offers in your municipality with the official FOPH premiums.
• Compare insurers: you receive the same subsidy at every insurer; it is paid directly to the insurer. Key figures for the insurers are listed under health insurers.

Common mistakes

• Believing the 10% limit applies. The initiative was rejected. There is no nationwide cap on the premium burden.
• Waiting for an automatic increase. The counter-proposal obliges the canton to a minimum budget, not to a specific amount for you. Depending on the canton, you have to apply for the subsidy yourself.
• Overestimating the minimum share in 2026. In 2026 and 2027, 3.5% applies everywhere. The graduated calculation only takes effect from 2028.
• Confusing the initiative with the cost brake. One sought to limit the premium burden, the other the growth in costs. Both were rejected, and each has a different counter-proposal.

How we prepare premiums and cantonal rules is explained under How we calculate.