South Korea's Ministry of Health and Welfare is pursuing a reform of the national health insurance premium system to increase payments for ultra-high earners [1].

The move seeks to address long-standing equity disputes and deteriorating fiscal health within the national insurance fund. Under the current system, individuals with significantly different income levels—such as those earning 130 million won versus 1 billion won per month—pay the same premium amounts [1].

The proposed plan will raise the monthly premium ceiling for ultra-high earners by more than 1.5 million won [1]. Specifically, the government intends to increase the upper limit for high earners from 30 times the average premium to 40 times [1]. This adjustment would raise the maximum monthly out-of-pocket cost from 4.59 million won to 6.12 million won [1].

Officials are also reviewing a plan to raise the upper limit for regional subscribers to 20 times the average premium [1]. Beyond the ceiling, the ministry plans to modernize the premium floor, which has remained fixed for 26 years [1].

The government expects the reforms to generate approximately 751 billion won in additional annual revenue [1]. The impact of the ceiling increase will be concentrated among a small fraction of the population, affecting 0.04% of workplace subscribers, and 0.02% of regional subscribers [1].

"The government is pursuing a reform of the health insurance premium imposition system," a YTN anchor said [1]. Reporter Yeom Hye-won said that the current system treats those earning 130 million won and 1 billion won per month the same [1].

“The government is pursuing a reform of the health insurance premium imposition system.”

This policy shift signals a move toward a more progressive taxation-style structure for health insurance in South Korea. By targeting a tiny fraction of the population—less than 0.1% of subscribers—the government aims to secure significant revenue without triggering widespread public backlash, while simultaneously correcting a structural anomaly where the wealthiest citizens paid a disproportionately low percentage of their income toward public health.