More than 600,000 Romanians were left without health insurance after the co-insured status was eliminated. In poor counties, their number is significant. In this context, the Emergency Reception Units are suffocated with patients.
Many Botošan residents choose to go directly to the Emergency room PHOTO Cosmin Zamfirache
The austerity measures taken by the Government since the beginning of autumn, especially regarding health insurance have unwanted effects especially in the poor counties of Romania, where the number of co-insured was quite high. In this context, without health insurance, more and more people go directly to the Emergency Department to receive medical care. A good example is Botoșani county, one of the poorest, at least statistically, in Romania. The director of the hospital as well as the staff at the Emergency Reception Unit say that the number of patients increased significantly after the Government eliminated the co-insured status, and this can lead to employee burnout.
Housewives County and tens of thousands of people without health insurance
By Law no. 141/2025, the co-insured status was eliminated in Romania. This is mainly a husband, wife, parents with no income who were getting health insurance through that family member who was working and paying for health insurance. The measure was taken so that there would no longer be insured persons without a contribution to the public health system. In poor counties these co-insured are quite numerous. In Botoșani County, for example, there were 13,900 co-insured. Of these, nearly 12,000 have remained without health insurance since September 1.
“At the level of the Botoșani County Health Insurance House, on July 31, 2025, a number of 13,900 people were registered in the co-insured category. As a result of the legislative changes, approximately 11,800 people left this category”, states Alina Mustiață, director of the Botoșani County Health Insurance House.
And this in the conditions where, in Botoșani county, more than 36,000 people are declared housewives. In conclusion, the number of uninsured people at the county level is quite high at the moment. Many of the former co-insured were housewives. “I know an employee who has three children. The wife is pregnant with the fourth. She didn’t go to work because she was taking care of the little ones. Who’s going to take care of them? He goes and works. Now she has no insurance.”confesses a Botošan resident.
Emergencies taken by storm by the uninsured
Part of those left without insurance, because they can no longer benefit from a consultation with the family doctor and are not willing to pay the CASS contribution, go directly to the Emergency Department when they have any kind of health problem. In this way, I receive free consultation, medical tests, investigations and even a prescription. The director of “Mavromati” Botoșani County Hospital says that the number of patients at the Emergency Reception Unit has increased significantly since September 1. More precisely, it is also about 80 patients, in addition, per day.
“It was expected that the lack of quality to be insured, or rather to be co-insured, would lead to a fairly significant increase in presentations at the UPU. If before there were 200 patients per day, now there are 250-280 presentations per day. Somewhere around 50-80 more presentations per day compared to the previous period”, stated Corneliu Prepelita, director of the County Hospital.
This situation is also confirmed by the chief doctor at the “Mavromati” Emergency Reception Unit. The risk is that the medical staff will be overworked.
“The Emergency Service has a significant number of presentations exceeding 200 as an average per 24 hours. It is very true that this strategy of the Minister is not one that benefits the emergency service because we do not differentiate between insured and co-insured or uninsured. For us, patients who present themselves in the emergency service are evaluated, assigned a color code and are examined by the medical body against the relevant times color code and treat. A part of them remain hospitalized, and a part, the largest, we say, goes home for treatment. How does it affect the medical body? Obviously through overwork and fatigue that reaches the chronic stage. We are trying to manage this situation as best as possible so that patients do not wait too long, we do not prolong these waiting times”says UPU chief physician, Ramona Guraliuc.
What should people who are no longer co-insured do?
Specialists from the County Insurance Houses say that there are different alternatives for those who are left without the quality of co-insured. Especially those who can prove that they are chronically ill, included in the national health programs. A variant is the minimum inclusion income.
“Those who do not have any form of insurance if they are chronically ill, if they are included in the national health program can come with a certificate from the attending physician and are registered as insured and benefit from medical services both within the national health program and for all other diseases until December 31, 2025. Starting from January 1, 2026, it will be seen what legal provisions will be applicable in this situation. These people can also benefit if se falls under a minimum income of inclusion. And for this person the income payer withholds the health insurance contribution at source. In this situation, the persons acquire the status of insured. But these people can be insured with payment by presenting themselves to ANAF. There they will submit a declaration and pay the health insurance contribution”states Alina Mustiață.
