Social Security Financing Act 2022: Key measures

The 2022 Social Security Financing Law (PLFSS) incorporates the implementation of the commitments of the Ségur de la santé and in particular the upgrading of the salaries of caregivers, the “independent” plan presented on 16 September by the Prime Minister, measures concerning the loss of autonomy, prevention and access to care. The 2022 social security budget, like the 2020 and 2021 budgets, is affected by the health and economic crisis. The social security deficit (general scheme and old-age solidarity fund) is estimated at 33.5 billion euro in 2021. It is expected to decrease to €20.4 billion in 2022. The law was enacted on December 23, 2021 and published in the Official Journal of 24 December 2021.

Main measures for individuals

The 2022 Social Security Financing Act provides for measures to improve prevention and access to care, strengthen support measures for loss of autonomy, combat unpaid maintenance, and better finance the use of personal services by individual employers.

The main measures for health expenditure and access to care are:

Free contraception for women under 26: since 1^er January 2022, the Health Insurance 100% and without advance payment, the cost of contraception and related procedures (annual consultation with a doctor or midwife and potential laboratory tests). Until that date, this care was provided for women under 18.

Mandatory early postnatal maintenance: starting on 1^er july 2022, a mandatory early postnatal interview will be conducted between 4^e and 8^e week after delivery. It will be fully covered by the Health Insurance. The goal is to detect early signs of postpartum depression.

Easier access to visual care: orthoptists may do visual assessments without a prescription and prescribe eyeglasses or contact lenses for minor corrections.

Third-party paying: the obligation of paying third parties is reinforced for equipment of 100% Health (optics, dentistry, audiology).

Direct access to physiotherapists and speech therapists: Experimentation in six departments of direct, non-prescription access to physiotherapists and speech therapists working in coordinated care facilities.

Mental health: consultations with a city psychologist from the age of 3 years on referral from a doctor will be taken care of by the Health Insurance. The number of annual consultations will be specified by Order in Council. This is a result of the mental health foundation of late September 2021.

More coordinated care pathways: generalization of the management of pregnancy diabetes by remote monitoring and the experimentation (Nord and Pas-de-Calais) of the prevention of childhood obesity “Mission: Rediscovered Ton Cap” (MRTC). This new multidisciplinary care pathway for children aged 3 to 12 is designed to prevent the development of persistent adult obesity and metabolic complications. Experimentation with HIV testing in a medical biology laboratory, without a prescription, (“Au Labo Sans Ordo”) is widespread.

Support for remote monitoring by the Health Insurance: deployment and support of telemonitoring by the Health Insurance. Remote monitoring allows a healthcare professional to remotely interpret the data needed for the medical follow-up of a patient and, if necessary, to make decisions for the management of that patient. A flat-rate fee will be introduced for people with five chronic conditions (diabetes, heart failure, kidney failure, respiratory failure and implantable therapeutic heart prostheses). The widespread use of remote monitoring should make it possible to improve the monitoring and quality of life of chronic patients by reducing in particular the number of trips they make.

Facilitated access to the complementary health solidarity (CSS): the supplementary solidarity health is automatically granted to beneficiaries of the RSA and the minimum old age without any action, unless they expressly oppose it. The procedures for beneficiaries of the Solidarity Allowance for the Elderly (Aspa) are also simplified.

Covid-19 work stoppage: extension of waiver rules for compensation for parents of children in isolation, insured persons tested positive for Covid-19, travelers having to comply with a quarantine measure. The latter are entitled to sick leave without pay and without application of the waiting period, when they are unable to work from home. This derogation regime is maintained until a date to be determined by an order in council to be published, and no later than December 31, 2022.

The main measures concerning family and autonomy are:

Strengthening the public maintenance service: In order to strengthen the prevention and fight against unpaid maintenance, unless the parents refuse, all newly fixed maintenance payments will now be paid through the Agency for the Recovery and Intermediation of Maintenance Payments (Aripa). This intermediation service will apply from 1^er march 2022 for divorces before the courts fixing maintenance, from 1^er january 2023 to other types of court decisions concerning maintenance and divorce by mutual consent.

Real-time payment of the personal services tax credit and social assistance: generalization of the immediate advance of the tax credit in 2022. Taxpayers can, if they wish, immediately collect the tax credits and benefits they receive for the costs of providing personal services. The cash advance made by individuals shall be totally canceled:

• From January 2022 for private employers of home helpers for household or family tasks (housekeepers, gardeners, teachers for private lessons...).
• As of April 2022, this option will be available to individual employers using a provider (business, association) in the personal service sector.

Supporting home support for older adults who are losing independence: upgrading of the salaries of employees of home support services, introduced from 1 January 2022 a minimum hourly rate of €22 for home care nursing services (SAAD), restructuring of home care services and ensuring their best funding throughout the territory, strengthening medicalization of Ehpads and links with home care services.

Caregiver leave: the conditions of the care leave will be improved (enlargement of its beneficiaries) and the daily care allowance will be increased to the Smic level, i.e. 58 € net per day by the end of 2022. The parental leave allowance (PJA) is also improved (620 continuous days).

The main measures concerning employees, self-employed persons and farmers are:

Phased retirement: employees on a fixed-day basis will be able to access progressive retirement, i.e. receive a fraction of their retirement pension while continuing to carry out one or more activities. This phased retirement was previously available only to employees whose working time was calculated in hours. The phased retirement scheme is also extended to certain self-employed workers covered by the employees' scheme (social agents, sellers at independent homes, etc.).

Self-employed: safeguarding the pension rights of the self-employed in the sectors most affected by the crisis, simplifying the calculation and collection of contributions by the self-employed.

Long-term partial activity: extension until end 2022 of the provisional provisions on long-term partial activity agreements which allow employees to receive additional allowances.

Farmers: a death capital of almost € 3 500 is created for the families of self-employed farmers who died after illness, accident or suicide. Until now, only agricultural workers could benefit from it.