Proposed rebate changes to affect 3 million Australians and add further pressure to the healthcare system 

As a member-owned, not-for-profit health fund committed to delivering value and protecting access to care, Westfund is concerned the changes may fall hardest on those least able to absorb them, increasing costs for older Australians and adding further pressure to the health system. 

Matthew Koce, Chief Executive Officer at the Members Health Fund Alliance, said independent analysis shows that around 3 million older Australians - roughly 1 in 5 people with private health insurance could face noticeably higher prices from 1 April 2027. 

“The changes proposed by Government are equivalent to an average premium increase of around 9 per cent, with some members facing rises closer to 12 per cent, or about $400 a year, on top of normal annual increases,” Mr Koce said. 

For some households, particularly older couples on Gold cover, premium increases could exceed $1,000 and in some cases reach $1,600. 

The financial impact is concentrated among lower-income Australians, with around 70 per cent of insured people aged 65 and over earning $55,000 or less. This means much of the burden would fall on those least able to afford it. 

These figures reflect the direct cost impact and do not yet account for how people will respond. Some may downgrade their cover or delay care, choices that can lead to longer-term health problems and greater reliance on a public system that is already under pressure, where waits can extend over a considerable time. 

Mark Genovese, Chief Executive Officer at Westfund Health Insurance, said the changes come at a difficult time for older members. 

“For many of our members, this represents a real and immediate cost-of-living pressure at a time when their healthcare needs are increasing,” Mr Genovese said. “We are already hearing from older Australians on fixed or modest incomes who are reassessing whether they can afford to keep their current level of cover.” 

“Adding to the health costs faced by seniors raises real concerns about fairness, and we are asking the Government to reconsider its position. Across regional communities, where access to timely care is already stretched, even small cost increases can have meaningful consequences.” 

Mr Koce added that the measure had been introduced without consultation. 

“This is a significant change made without consultation, and it will affect millions of Australians during a cost-of-living crisis,” he said. “A price rise of up to 11.9 per cent will be felt most by lower-income seniors and long-standing fund members who depend on private health insurance for timely, high-quality care. It may lead many Australians to reconsider their cover, with potential implications for private hospital viability and public hospital waiting times.”