Starting April 1, 2024, France will see significant changes to its sickness benefit system, with daily indemnities recalibrated to address mounting public spending concerns. The government has decided to lower the upper limit for daily sickness benefits from 1.8 times the minimum wage (SMIC) to 1.4 times, effectively reducing the maximum indemnity from €53.31 to €41.47 per day.
This reform aims to tackle what the Caisse nationale d’Assurance-maladie (CNAM) and the Court of Auditors have identified as unsustainable growth in sickness-related expenditures, which have surged by 52% since 2015. Estimates suggest these expenses will reach €17 billion by the end of the year, prompting immediate government intervention.
The decree implementing these changes was initially discussed as part of the 2025 Social Security Budget but is anticipated to be finalized and promulgated shortly. The health ministry emphasizes the necessity of these reforms as part of broader fiscal responsibility initiatives, hoping to save €400 million annually.
While the government claims the move will align sickness benefits with other social safety nets, critics worry about its impact on workers, particularly those earning moderate wages. The new guidelines are expected to principally affect higher-income employees who may find their benefits reduced significantly when on sick leave.
Employees currently benefiting from sickness payouts will see their daily compensation impacted directly by this cap reduction. Those on contracts shorter than one year or those who have not held their jobs for over 12 months may face markedly lower compensation during sickness, as their entitlement to company-paid supplements may not apply.
For example, under the pre-reform rules, employees could receive up to 100% of their salary during their sick leave for the first month of absence; this will now be curtailed. Workers with one year of seniority will still enjoy 90% coverage for the first month, but their additional salary supplement obligations will fall heavily on employers, who must cover the gap between the new state compensation and the usual salary.
Critics of these reforms express concern over the potential strain on lower-income workers, particularly among young professionals and those with precarious job contracts. The Centre technique des institutions de prévoyance (CTIP) suggests more than half of all employees—around 13 million workers—will experience this financial squeeze. They stress the inadequacy of the reforms, claiming employees could lose nearly €360 per month from their income due to this cap.
The government maintains, nevertheless, the necessity for these measures amid warnings of increases to the social security deficit, which is projected to exceed €22 billion by 2025 if expenditures are not curtailed. The aim is to achieve immediate financial relief for the social security system primarily supporting sick employees through these budgetary adjustments.
The transition to lower sickness benefits echoes similar reforms pushed through various sectors of employment over the past decade and raises pivotal questions about the balance of financial responsibility and employee welfare. The increased burden on employers means many will need to assess their compensation strategies proactively to align with the new health regulations.
The outcome of these reforms remains to be fully assessed as they roll out; employers and employees alike will need to adapt quickly to these adjustments. Observers warn of now-necessary conversations around adequately protecting vulnerable workers during illnesses, particularly when sickness absence can significantly threaten job security and financial stability.
These drastic changes have prompted conversations around effective and fair employee wellness strategies, and whether the current safety nets can withstand pressure as balancing public health and fiscal responsibility becomes every more complex. With the government's commitment to fiscal restraint, monitor whether this new approach achieves its intended savings or leads to civil unrest among poorly supported workers.