https://www.yomiuri.co.jp/politics/20250705-OYT1T50046/
According to a survey conducted by the Ministry of Health, Labour and Welfare targeting 150 municipalities, the National Health Insurance (NHI) payment rate for foreign nationals remained at 63% as of the end of 2024. This figure was lower than the overall payment rate, which includes Japanese nationals, of 93%.
Currently, the NHI system operates by mailing payment slips to individuals after they enroll. However, it's believed that some foreign nationals, particularly those from countries without similar systems, may not understand the obligation to join NHI and thus fail to pay. Both ruling and opposition parties have called for the introduction of prepayment options, citing cases where "foreign nationals who haven't joined NHI are defaulting on medical expenses."
The Ministry intends to target newcomers from overseas, envisioning a system where municipalities can request a lump-sum advance payment of premiums, such as for a full year, when foreign nationals register their residency. The Ministry plans to issue a notification to local governments within the current fiscal year.
A prepayment system already exists for National Pension premiums, which are uniform nationwide. However, NHI premiums vary by municipality. Therefore, if a foreign national moves to another municipality after prepaying, a portion of the advance payment would need to be refunded. This would create a new burden for municipalities, so the decision to implement a prepayment system for NHI premiums will be left to the discretion of each local government.
The Ministry will also begin modifying its system to track the NHI payment status of foreign nationals. Currently, most municipalities cannot ascertain the payment status of foreign nationals due to the inability to confirm their nationality or residence status. After the modifications are completed by the end of fiscal year 2026, the system will be designed so that the Immigration Services Agency of Japan can utilize the information for residence status reviews by around June 2027.
The government further aims to similarly share payment information for pension premiums and medical expenses in the future. Their goal is to implement measures such as not approving residence status renewals for foreign nationals who have outstanding payments.
by 100rad