Morocco’s mandatory social health insurance scheme is being reviewed to include workers such as artisans, taxi drivers and farmers. Insurers in the country will have to manage the migration of customers and the expansion may impact premium income.

Morocco has made progress in getting coverage for its citizens under its mandatory health insurance scheme, also known as Assurance Maladie Obligatoire (AMO). The country’s medical coverage rate reached 70% of beneficiaries at the end of 2021, according to a report by news outlet Atalayar. The report said this comprises 25.2m people, including 11.17m who are under AMO and 11m who benefit from the medical assistance scheme known as RAMED – a system that covers those without the means to pay.

Proposals are under review to expand AMO in 2022 to workers such as artisans, taxi drivers and farmers. The AMO provides full and comprehensive health coverage, including childbirth, medical/surgical hospitalisation and childcare up to the age of 12, medical devices and implants required for medical and surgical procedures, refundable medicines and prosthetic devices.

Impact on insurers

An expansion of the AMO is likely to bring both impact and opportunities for the health insurance sector in Morocco.

BMCE Capital senior analyst Khadija El Moussyli said that the expansion of the AMO would not be without impact both on the supply of health insurance and on non-reimbursable expenses (NR). She said this during a webinar which had the theme ‘Insurance sector perspectives’, according to a report in L’Opinion, an online electronic publication of the Rabat-headquartered press group ARRISSALA.

“The impact on turnover should be negative due to the migration of a category of customers to the public sector. On the other hand, the impact relating to NR can be positive in the sense that the broadening of AMO should push insurance companies to switch to complementary products that are much more profitable than basic ones,” she said.

Since a clear deadline and milestones have been set for the actual implementation of the reform, the preparation of the insurance ecosystem have been accelerating and the attitude has moved from slight apprehension in front of the changes, to the realization of the new doors that the reform opens… said Nextcare Morocco general manager Laurent Billaud, speaking to Middle East Insurance Review.

Potential restructuring

Mr Billaud said insurers see the AMO as an important opportunity and have been preparing actively for the new developments. Some individual health products complementary to the AMO are already launched and he expects more to come to the market by the end of the year while some others are in preparation.

“Through the generalisation of AMO, an additional 22m Moroccans will have a better and more secure access to the healthcare system. This is the essence of a reform which is going well beyond a simple change affecting only the health insurance market,” he said.

He said that the expansion of the AMO is also expected to lead to restructuring of the health insurance market, especially in the group health insurance sector.  He added that client companies already offering health insurance to their employees will by law have to maintain at least the same level of coverage, but the AMO premium will cover part of it for the private insurance market.

“Generalisation of AMO also means a shrinking premium cake which will affect the revenues and margins of all players. This new deal may have important consequences on the stability of a well-established market structure, organised around a dozen strong intermediaries managing the competition between the main insurers through group health insurance, which is always at the limit of profitability, but is the open door to more lucrative corporate business,” he said.  

Details for implementing an expansion of the AMO have not been set out. Mr Billaud said social and economic acceptance of the reform would also depend on the actual articulation between public and private payers.

“Will there be a ‘guichet unique’ (a one-stop shop) which would allow insureds to claim at once for the AMO and complementary products? Who will be the main point of contact for the insured? Public payers, intermediaries, private insurers?” he said.

“For the time being not everything is clearly set – leaving the door open to different scenarios. In the more optimistic one, AMO generalisation nudges the players to increased collaboration, rationalisation, simplification and digitalisation of the processes and ultimately helps foster a reorganisation of the healthcare offering which is more transparent and accessible,” he said.

“The future surely lies somewhere in between these two extremes. It is time for all market players to take responsibility and leverage the generalisation of AMO as a tool for the necessary modernisation of the entire Moroccan health insurance market.”

ENDS