[Edaily Reporter An Chi-yeong ] The policy to subsidize nursing care costs at long-term care hospitals—one of the Lee Jae-myung administration’s key national agenda items—is already sparking controversy even before its full implementation. This is because the government is considering not only reducing the eligibility period for long-term hospitalization support under the National Health Insurance System from the original 180 days to 120 days but also increasing the patient copayment rate after 120 days of hospitalization.

Consequently, concerns are being raised that this policy—intended to alleviate the burden of nursing care—may not provide sufficient assistance to patients requiring long-term treatment and their caregivers (family members).

According to internal documents from the Ministry of Health and Welfare and sources in the medical community on the 3rd, it has been confirmed that the government is discussing a plan to strengthen the criteria for reducing support based on the length of hospitalization as it adjusts its proposal to include nursing care costs at long-term care hospitals under health insurance coverage. The inclusion of nursing care costs under health insurance is a system whereby the National Health Insurance Service covers a portion of the nursing care costs previously borne by patients and their families.

The proposal under review provides a basic level of support for up to 120 days of hospitalization but, beyond that, gradually reduces the nursing care fees paid to hospitals while increasing the portion paid by the patient. This effectively brings forward the reduction in support—originally planned to apply after 180 days—by about two months. While support is not completely cut off after 120 days, benefits decrease as the hospitalization period lengthens.

The government is considering lowering the basic copayment rate from the original 30% to 20%. While this will reduce the financial burden for patients with short-term hospitalizations, it will shorten the period during which patients with long-term hospitalizations receive the basic level of support. This is why it is difficult to conclude that benefits for all patients have increased simply through the reduction in the basic copayment rate.

The timeline for expanding eligibility has also been delayed. The government has adjusted its plans to include support for caregiving costs for certain patients with moderate conditions—such as those with Parkinson’s disease and severe dementia—starting in 2029, rather than at the program’s launch. This has raised concerns that a gap in support may arise for patients who require significant assistance with daily living.

The projected financial outlay from the National Health Insurance Service has also decreased. According to internal data from the Ministry of Health and Welfare, the fiscal projection for 2027–2030 has been reduced from the original 5.37 trillion won to approximately 2.8 trillion won.

The medical community points out that, regardless of the intent to reduce unnecessary long-term hospitalizations, support for patients who require treatment should not be cut based solely on the length of their hospital stay. An official from the Korean Hospital Association stated, “Even with the same symptoms, some people may see improvement within a month, while others may continue to experience symptoms for a year,” adding, “It is necessary to extend the support period or make exceptions depending on the patient’s condition.”

The Korean Association of Long-Term Care Hospitals also opposes the cuts to nursing care fees. They argue that if the nursing care fees hospitals receive are reduced, it will become difficult to maintain staffing levels, which could lead to a decline in service quality. There are also concerns that patients’ financial burdens will increase and that hospitals, in an effort to encourage discharge, may pressure even patients who require inpatient treatment to leave the hospital. Ahn Byeong-tae, vice chairman of the Korean Association of Long-Term Care Hospitals, has categorically rejected the cuts to nursing care fees.

Patients, too, are opposed to the cap on the length of stay. Ahn Ki-jong, President of the Korea Federation of Patient Organizations, stated, “Even for long-term inpatients, we should assess whether nursing care is necessary and continue support if needed,” adding, “While we can review the need for nursing care more strictly, it is not appropriate to force patients to transfer to another hospital simply because their hospitalization period has expired.”

Meanwhile, the Ministry of Health and Welfare has indicated that while it is reviewing the matter from various angles, it is difficult to officially confirm specific figures or details at this time.