BERN. The most reliable ritual of the Swiss political year is due within days. In the last week of September, as it does every year, the Federal Office of Public Health will publish the approved average premium for basic health insurance for 2027, and the health minister will step in front of the cameras to call the number unsatisfactory. Last year the announcement fell on 23 September. This year the office has given no date, and the insurers’ letters must follow by the end of October. The forecasts have been public for months. They span a wide and politically useful range: 3.7 per cent, or 5.
The optimistic end belongs to Comparis, which projected a 3.7 per cent average rise back in May and has held it since. The pessimistic end belongs, unusually, to the government itself: the health office warned in late May of 4.5 to 5 per cent, and the Lausanne based comparison service bonus.ch reached the same range in September. The doctors’ association of French speaking Switzerland offers the outlier: on its reading of the cost data, 2 to 2.5 per cent would be justified, a figure nobody in the insurance industry recognises.
Whatever lands will be the fifth consecutive above inflation rise. The increases read like a drumbeat: 6.6 per cent for 2023, 8.7 for 2024, 6 for 2025 and 4.4 for 2026, which lifted the average monthly premium to CHF 393.30. Since 2022 the average has climbed from CHF 315, a rise of almost 25 per cent in four years, against cumulative inflation of a fraction of that. The average household now spends more on mandatory health insurance than on anything else after housing and taxes.
The average, when it comes, will hide almost everything that matters. Premiums vary by canton, by insurer and by age group, and the spread around the headline number is wide: bonus.ch expects some insured to face rises approaching 20 per cent while others see almost none. The federal figure is a weighted mean of thousands of individual tariffs, useful for politics and nearly useless for planning. The letter that actually matters is the one with your name on it, and insurers must send those by 31 October.
Underneath the forecasts sits a single accounting fact. The health office estimates the combined ratio for 2026 at almost 101 per cent, meaning premiums this year do not quite cover the costs they are meant to pay for. That gap produces what actuaries call a catch-up effect: part of the 2027 rise is not new cost growth but the recovery of this year’s shortfall. The KOF research institute projects costs per insured rising from CHF 4,968 in 2025 to about CHF 5,191 this year and close to CHF 5,400 in 2027, a slowdown in the rate of growth, but not a turnaround.
The political response is already in session. Parliament is arguing over the same levers it has argued over for a decade: franchise reform, outpatient tariffs, the shift of care out of hospitals, and a pay cap for insurance executives that the government itself concedes will not move premiums. The announcement lands in the middle of the autumn session, and every party has a motion ready for the morning after.
For households the actionable facts are three, and they do not change. The letter arrives by the end of October. Cancellation of the basic insurance must reach the current insurer by 30 November, full stop. And the savings are real: switching model, raising the franchise or changing insurer is worth hundreds of francs a year for identical mandatory cover. Fewer than one in ten insured actually switch. The ritual depends on it: the letter, the irritation, and the renewal by default. The number due within days will test, once again, how much irritation the default can absorb.