25/10/2026
Monday Money Talk with Noel Whittaker
Private health insurance rebates are back in the headlines, with a fierce political battle unfolding in Canberra. Labor wants to cut the rebate for Australians aged 65 and over; the Coalition and Greens oppose the move. The motion to strike out the bill was led by Senators Jacqui Lambie and Anne Ruston. The Greens have indicated they may compromise, but only if pensioners are protected.
The rebate was introduced by John Howard in 1999 to encourage take-up. It was initially set at 30% for everyone. In 2005, his government increased it to 35% for people aged 65 to 69 and 40% for those aged 70 and older. Subsequent governments reduced those percentages and introduced income testing.
Today, the rebate depends on both age and income, with higher-income earners receiving a smaller rebate or none at all. Once income exceeds $328,000 for couples or $164,000 for singles, the rebate disappears entirely. But within each eligible income bracket, Australians over 65 still receive a higher rebate than younger people.
That's what Labor wants to abolish from 1 April 2027: not the entire rebate, but the additional age-based concessions. The government argues that taxpayers shouldn't subsidise older Australians more generously simply because of their age. There's some logic in that, particularly when wealthy retirees can qualify for concessions unavailable to younger families struggling with mortgages and living costs.
But there's another side to this. Many older Australians have maintained private health insurance for 30, 40 or even 50 years, faithfully paying premiums that have added up to tens of thousands of dollars. For much of that time, when they were younger and healthier, they may have made relatively few claims. Their premiums helped support the system year after year. Now, when they are older and more likely to need medical treatment, the government proposes to reduce the rebate that helps them maintain their cover. There's something fundamentally unfair about changing the rules at precisely the stage of life when long-standing policyholders are most likely to need the protection they've been paying for. Increasing premiums is likely to encourage thousands to abandon private cover or downgrade their policies, putting more pressure on an already overstretched public hospital system. And that's where the government's sums may start to unravel.
National Seniors Australia, the peak advocacy consumer body for older Australians, has released survey findings suggesting that 15% of seniors will most likely drop their private health insurance and another 16% will most likely downgrade their cover to cope with the increased cost. If those survey results were reflected across the wider population, an estimated 480,000 people could abandon private health insurance altogether, while up to 560,000 could reduce their level of cover. That's substantially more than the government estimates.
And here's the catch-22: if older Australians downgrade their policies to save money, they may sacrifice the very benefits they're most likely to need. Downgrading higher-level hospital cover, for example, could mean not being covered for important procedures, such as hip and knee replacements, which are more likely to be needed in later life. Dropping or downgrading extras cover could mean losing assistance with dental treatment, optical services and physiotherapy. These are hardly luxuries for people in their seventies and eighties.
This is why the impact should not be measured only by the number of people who cancel their cover. Downgrading policies, delaying healthcare and sacrificing other essentials have equally serious consequences.
The government says the changes will improve the budget position, with estimated savings of around $3 billion over four years. But what happens if hundreds of thousands of older Australians reduce or abandon their private cover? Most who need care will turn to the public system, where waiting lists are already stretched and hospitals are struggling to cope.
Meanwhile, older Australians are waiting months for Support at Home care packages, which remain rationed. Thousands of patients are also stranded in public hospitals because suitable aged care accommodation or support isn't available. Just this week, I heard a chilling account on ABC radio from a woman whose elderly mother had spent more than two days on a stretcher in a public hospital corridor. She couldn't visit because access was restricted, and her mother found it almost impossible to get someone to help when she needed to use the toilet. What an indignity for anyone who is already ill and vulnerable.
Surely, if the government is determined to cut the rebate, any savings should be directed towards fixing these problems, rather than simply disappearing into general revenue.
There's a final sting in the tail. If the legislation passes, the cuts will take effect on 1 April 2027, the very day private health insurers traditionally increase their premiums following government approval. Older Australians could therefore face a double blow: higher premiums and a reduced rebate on the same day.
The government may regard this as a sensible budget saving. But if the result is greater pressure on public hospitals, because thousands of older Australians abandon private health insurance, it could prove to be one of the most expensive savings exercises imaginable.
Through its ongoing Health Costs campaign, National Seniors Australia is advocating for a fairer, more affordable healthcare system. Visit nationalseniors.com.au to join the campaign and help ensure older Australians' experiences are heard.
Noel Whittaker is the author of Retirement Made Simple, Wills Death and Taxes and numerous other books on personal finance. Email: [email protected]