[Yonhap]
[Yonhap]

The government is pushing to impose national health insurance premiums on daily workers who earn more than 20 million won ($13,600) a year. The move comes after cases emerged of high-income daily workers paying only the minimum premium or retaining dependent status despite substantial earnings.

According to health and medical circles, the Ministry of Health and Welfare presented a reform plan for the national health insurance premium system at a subcommittee meeting of the Health Insurance Policy Deliberative Committee on Thursday.

The government said it is pursuing the reform to improve premium equity between workplace subscribers and regional subscribers and to strengthen the fiscal foundation of the national health insurance system.

Under the proposed reform, 50 percent of daily labor income exceeding 20 million won per year would be counted toward the premium calculation base.

According to National Tax Service data, 5,282,568 daily workers reported income in 2024, of whom about 5.2 percent earned more than 20 million won annually.

By income bracket, the largest group — 144,761 people, or 2.7 percent — earned between 20 million won and 30 million won a year, followed by 67,288 people (1.3 percent) in the 30 million to 40 million won range, 33,237 people (0.6 percent) in the 40 million to 50 million won range, and 29,969 people (0.6 percent) earning more than 50 million won. The roughly 5.007 million workers who earned 20 million won or less annually would not be subject to the new levy.

The government estimates the reform will affect 55,000 workplace subscribers (0.3 percent) and 170,000 regional subscriber households (1.8 percent). An additional 49,000 people (0.3 percent) are expected to lose their dependent status and begin paying premiums independently.

The government projects the changes will generate an additional 265.8 billion won in national health insurance revenue each year.

Under the current National Health Insurance Act, daily labor income is technically subject to health insurance premiums, but in practice the government has not levied them, largely due to the perception that daily workers belong to a vulnerable income group.

As a result, some workers earning substantial daily wages have been able to maintain dependent status or pay only the minimum premium.

Cases confirmed last year include a construction-sector daily worker who earned 140 million won — working 230 days at 600,000 won per day — while remaining registered as a dependent, and another who earned 110 million won — working 285 days at 400,000 won per day — while paying only the minimum regional subscriber premium.

Foreign workers in South Korea, who collectively earn close to 10 trillion won in daily labor income each year, have also in effect been excluded from health insurance premium obligations, fueling longstanding equity concerns.

The Ministry of Health and Welfare plans to revise the enforcement decree and regulations of the National Health Insurance Act based on the reform proposal. Once finalized, the changes are expected to establish clearer premium standards for high-income daily workers and help narrow the premium burden gap between workplace and regional subscribers.


rainbow@heraldcorp.com