Tajikistan's Ministry of Health and Social Protection of the Population (MoHSPP) has announced that the implementation of a mandatory health insurance (MHI) system will be postponed until after 2030.
Development of MHI system
An official source within a MoHSPP says the ministry has developed several draft regulatory documents addressing key aspects of the MHI system. These include guidelines for paying insurance premiums, the basic MHI program, and regulations regarding the Mandatory Health Insurance Fund. These drafts are currently under review and coordination with other government ministries and agencies.
The introduction of the law "On Health Insurance in the Republic of Tajikistan" has been postponed to a period after 2030. This decision is based on objective circumstances, and at present, the MHI system is still in the preparation stage.
Insurance costs and additional payments
The source clarified that the cost of mandatory health insurance for citizens will be determined by the government. Under the MHI system, citizens will be provided with free medical services and medications listed in an approved list. Government support for low-income families will be provided from the state budget.
The quality of medical services within the MHI system will be monitored by the Ministry of Health and Social Protection. The effectiveness of service delivery will be overseen by the State Medical and Social Supervision Service. The list of services covered by the MHI system will be approved in coordination with the Antimonopoly Agency.
High-tech medical services will likely require additional payment.
Why was the introduction of MHI delayed?
The "On Health Insurance in the Republic of Tajikistan" law was passed in Tajikistan in June 2008. However, at that time, the parliament decided to postpone its implementation until 2010. But even after two years, no decision had been made.
At the end of 2022, lawmakers postponed the law’s implementation for the fifth time. During a parliamentary session, then-first Deputy Minister of Health and Social Protection, Ghafour Muhsinzoda, explained that, according to a report by the interdepartmental working group, the country had not yet created the conditions necessary for a full transition to a health insurance system.
Muhsinzoda noted that the introduction of MHI needed to account for economic, financial, and organizational requirements. He also explained that, according to the Ministry of Finance, "if insurance premiums were paid from the existing social tax rate, there was a risk of reducing revenues to the social insurance and pension budget, which could lead to the state failing to meet its social obligations to the population."
He also pointed out that international experience showed that in order to introduce mandatory health insurance, the necessary amount for the healthcare sector should be at least 4-6% of GDP. At that time, this figure in Tajikistan was 2.8%, with 80-90% of local budgets allocated for salaries.
For reference, the draft state budget for 2026 allocates 5.03 billion somonis for healthcare, which is approximately 2.5% of the country's GDP.
