Employees’ Contributions Now Go Directly to Private Health

The Cabinet of Advisors of the Ministry of Health issued Resolution 1/25 on January 30, 2025, with new provisions related to the direct derivation of contributions and duties to private medicine entities.

This resolution follows Decree 70/23 on Bases for the Reconstruction of the Argentine Economy, which incorporated a series of reforms in different areas and regulatory frameworks. Regarding social security, it regulated aspects related to healthcare benefits, specifically those of public and private healthcare insurances.

Following the Decree, private medicine entities (regulated through Law 26682) were incorporated to the regime of Law 23660 on public healthcare insurance, provided they first registered as health agents.

Later on, through Resolution 3284/24, the Superintendence of Health Services established that private companies offering healthcare plans, totally or partially financed with social security funds, had to register before the Argentine Registry of Insurance Agents (RNAS). It also established that they would not be allowed to commercialize such plans unless they complied with this requirement.

Although compliance with the registration was high, the Ministry of Health considered necessary to issue a new regulation to:

a) allow the Superintendence of Health Services to exercise effective control in the administration of resources coming from social security,

b) protect free competition and the principle of beneficiary’s free choice,

c) ensure a more equitable and efficient health system.

Considering all this, Resolution 1/25 established that public healthcare insurance contributions and duties could be directly sent to private healthcare insurance companies the beneficiaries contract. It also granted 60 days (which expired on March 30, 2025) for beneficiaries to state their will to continue with their healthcare insurance, without deriving contributions to the contracted private healthcare insurance company.

In short, what the Resolution established was the possibility for beneficiaries to choose if they want to continue with the private healthcare insurance, with direct sending of contributions and duties to such entity (without intermediaries), or if they wanted to obtain healthcare benefits from the public healthcare insurance company that received said contributions and duties.

This new regulatory framework opened a series of questions. The main concern is probably related to the medical benefits that, because of the agreement between entities, were generally granted by the public healthcare insurance and not by the private one.

A specific example of this is the medical benefit for disability. Law 24901 (System of Basic Benefits for Persons with Disabilities) expressly provides that healthcare insurances must fully cover the basic benefits included in this law. However, as of the mentioned resolutions, private healthcare entities were incorporated to the regime of Law 23660 (on public healthcare insurance), in addition to being registered as health agents, which means they would have the same obligations than public healthcare insurances. Further, Resolution 1/25 clearly states that “beneficiaries will maintain their rights without any modification that could imply a detriment to the contractual relation that binds them or to the access to medical benefits.”

In conclusion, the direct derivation of contributions that Resolution 1/25 provides should not imply detriments to the beneficiaries, in terms of medical benefits and/or healthcare coverage. However, it will be advisable to monitor the development of this new scheme from a practical perspective.

Finally, considering that the changes the Resolution introduced are relevant, supervening questions cannot be ruled out (e.g. from public healthcare insurance companies), specifically in relation to Decree 70/23 and its constitutionality, which has been challenged in different precedents (e.g., Caso “Wilson c/ Estado Nacional – PEN”).