Kazakhstan to Fund Health Insurance for Over A Million Unemployed Citizens

Beginning in 2026, more than one million unemployed and vulnerable citizens in Kazakhstan will be covered by the country’s compulsory medical insurance system (CMIS). Health Minister Akmaral Alnazarova announced that local and regional budgets will assume responsibility for insurance contributions on their behalf.

Expanding Access to Medical Coverage

Kazakhstan’s current health insurance model requires employed citizens to contribute 2% of their monthly salary, capped at 17,000 KZT (approximately $33), to the Fund for Social Medical Insurance (FSMI). Employers pay an additional 3% of each employee’s salary, while individual entrepreneurs contribute 5% of their income. However, unemployed citizens, even if officially registered, are presently excluded from the system.

In response to a directive issued by President Kassym-Jomart Tokayev in February 2024, the Ministry of Health has drafted legislation that would enable local governments to make insurance payments for unemployed and vulnerable groups. The bill was submitted to the Mazhilis, the lower house of parliament, for consideration.

“This is a step towards improving people’s health and quality of life,” Alnazarova said. “Local budgets will cover the contributions, and these individuals will receive insured status on a monthly basis, regardless of income.” The change is expected to extend coverage to over one million additional citizens, granting them access to scheduled medical care.

Systemic Reforms and Contribution Cap Adjustment

The ministry also proposes raising the upper limit for contribution calculations from 10 to 50 times the minimum monthly wage. As of 2025, one minimum wage is 85,000 KZT (approximately $165), making the new cap 4.25 million KZT (around $8,100). The adjustment would impact approximately 9% of employees, roughly 508,000 individuals, and their employers.

“In global practice, income limits are not applied. In our country, high-income earners currently pay proportionally less than others,” Alnazarova explained, justifying the reform as a measure toward fairness and sustainability.

Parliamentary Scrutiny of the Insurance Fund

The draft legislation has revived long-standing criticism of the FSMI’s governance. During recent Mazhilis debates, MP Murat Abenov accused the fund of lacking transparency and accountability.

“The SMIF checks itself, allocates funds itself, concludes contracts itself, and determines violations itself. Many infractions go unnoticed by both ministries and the public. If not for the Supreme Audit Chamber, we wouldn’t even know that billions are being embezzled,” Abenov stated during a parliamentary session.

This follows earlier opposition by several MPs to a proposed 10% tax hike on medicines and healthcare services during discussions surrounding the new Tax Code.