NHIF Budget Passes First Reading in Finance Committee

With 12 votes in favor and 8 against, the Parliamentary Committee on Budget and Finance approved the NHIF budget following heated debates. The draft was also scheduled for discussion in the Health Committee, but the meeting was canceled due to a lack of quorum.

During the discussions, members of parliament in the Finance Committee took diametrically opposed positions regarding the Fund’s budget and the allocation of healthcare resources. A point of contention was the removal of a text from the budget that provided for salary increases for medical professionals without a specialty and the introduction of fixed salaries.

“In the previous budget you submitted, there were €260 million for the salaries of not only doctors but also nurses and all hospital staff. I agree that wage regulation is best handled through collective bargaining, which was attempted in 2022. At that time, funds were also allocated for two funds—for remote and priority hospitals—to guarantee access to healthcare. To ensure healthcare services everywhere, additional funding for doctors and nurses is necessary, as many locations cannot implement enough clinical pathways due to a lack of patients. I truly do not understand what you have done in this budget,” stated MP Asen Vasilev from PP–DB.

He added that the budget’s philosophy includes an idea promoted by ITN to bring in medical professionals from abroad to work for a remuneration of 500 BGN. According to Vasilev, there is also an uneven distribution of funds—the increase for primary outpatient medical care (PIMC) is 6%, for specialized outpatient medical care (SIMC) it is 4.7%, while for hospital care and medications, the growth exceeds 10%.

Dimo Drenchev from “Vazrazhdane” noted that expenditure on medications has increased by 250 million BGN and asked whether increasing the share of generic drugs has been postponed until 2027 or if it could be implemented as early as next year. A similar opinion was expressed by MP Maria Ilieva from “Velichie,” who pointed out that medication costs are rising the fastest and called for measures to limit them.

In response to the questions, Minister of Health Assoc. Prof. Silvi Kirilov stated that a bill to amend and supplement the Law on Medicinal Products in Human Medicine has already been submitted to Parliament. According to him, it includes measures for full traceability of every medication package—from the manufacturer to the end consumer, including generic products. There are also plans to determine the necessity of each medication at 100% market saturation for a 12-month period. The law will come into force nine months after its adoption to allow for the adaptation of the information system.

During the meeting, the Chairman of the Parliamentary Health Committee, Prof. Kostadin Angelov, also spoke to journalists. He announced that a roughly 10% increase in the prices of clinical pathways is planned, with the majority of the funds being directed toward labor remuneration.

Prof. Angelov recalled that the previous draft budget, which included €260 million for salary increases in medical facilities, did not receive sufficient support from the NHIF Supervisory Board. However, the current draft of the Fund’s budget for 2026 was adopted by a majority from both the Supervisory Board and the National Council for Tripartite Cooperation, he specified.

According to him, the funds have not been dropped but redirected—the Ministry of Health’s budget includes €30 million for the launch of a program for medical residents, as well as another €30 million for income policy within the ministry’s structures, Zdrave net adds.