It is a Social Security budget transformed into a financial pit by the health crisis that Parliament must validate on Monday.
In the absence of agreement with the Senate dominated by the right-wing opposition, the 2021 PLFSS comes in the afternoon one last time before the deputies, whose vote will mark the final adoption at the end of six weeks of shuttle between the two bedrooms.
Read also: The Social Security deficit will remain abysmal for many years
On the right, we are alarmed at having to work on figures "already underestimated", without knowing when and how the deficits will be filled.
The left denounces for its part a budget "which provides only a short-term response to the crisis", in particular that of the hospital.
Here are the main points.
An extraordinary deficit
It continued to widen even during parliamentary procedure and the announcement of new health measures.
The security deficit for the current year is now estimated at 49 billion euros, against 46.6 billion announced at the start of the debates.
Small consolation, it is a little less than the 52 billion feared in June by the Social Security accounts commission.
The crisis will continue to weigh heavily on the figures next year: the "hole" planned for 2021 has also widened, with 35.8 billion euros against 28 billion initially expected.
An aggravation mainly due (6 billion) to the contraction of the wage bill caused by the crisis, which weighs on contributions.
An increasingly costly health crisis
Purchases of masks, reimbursements for tests, vaccination campaign, work stoppages, support for healthcare workers and the hospital ... The cost of the Covid-19 epidemic continues to climb.
The Minister of Health Olivier Véran announced to the National Assembly on October 20 an envelope of 2.5 billion, in addition to an already planned increase of 10 billion of the Ondam (National target for health insurance spending) for 2020. An extension intended in particular to open 4,000 hospital beds "on demand, from 2020", and also to finance an advance to December of the salary increases for staff promised under the "Ségur de la santé", and a "Overvaluation of overtime" during the health crisis.
Boosted paternity leave
It was a commitment by Emmanuel Macron: from next July, the duration of leave for a father - or the second parent - of an unborn or adopted child will be reduced from 14 to 28 days, of which 7 are compulsory.
The three days of birth leave will always be paid by the employer, and the remaining 25 days will be compensated by Social Security.
As is already the case, seven additional days will be added in the case of a multiple birth.
Price of the measure for the family branch: 260 million euros next year, then 520 million in 2022, in a full year.
Addiction gets its branch
The PLFSS acknowledges the creation of a fifth branch of social security, dedicated to the management of loss of autonomy.
It must be added to the four existing branches: sickness, retirement, family, work accidents.
For 2021, it is only financed by solidarity credits for autonomy (CNSA), as well as those dedicated to the education allowance for disabled children, AEEH.
The framework is set, it remains to find the money.
Minister Olivier Véran has promised "at least one billion euros" more for this branch, far from the 9 billion that should be added by 2030 in view of the increase in the elderly population.
But also...
Twelve new birth
centers, low-medical support places, must be created with a budget of 2 million euros.
Visioconference
consultations (teleconsultations), the number of which has exploded with the health crisis, will still remain 100% covered by the Social Security for 2 years.
The supplementary disability allowance
(ASI) will be increased from 2021 to 800 euros per month (compared to 750 euros currently).
The government will release 200 million euros so that
home helpers
who work with the elderly and the disabled can benefit from a salary increase of around 15%.
A "fixed price" of 18 euros
for people going to the emergency room will replace the current "co-payment" which leaves the patient with 20% of the cost of his care.
Systematic
full third-party payment
has been approved in the event of voluntary termination of pregnancy, a measure intended to guarantee the confidentiality of abortions.
The fight against fraud
will be stepped up, with possible automatic cancellation of Social Security numbers, and automatic deconventing in the event of a repeat fraud by a health professional.
Finally, deputies and senators imposed, against the advice of the government, a reduction in employers' charges for wine growers in order to help a sector severely affected by the crisis.