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Japan immigration

Health insurance in Japan to exclude family abroad

Upcoming bill seeks to rein in benefits as greater labor immigration looms

An emergency room doctor checks on a patient at a hospital in Tokyo's Shinjuku Ward. (Photo by Tsuyoshi Tamehiro)

TOKYO -- Overseas dependents of foreigners working in Japan would no longer be covered by medical insurance come 2020 under a legislative proposal that seeks to restrain ballooning health care costs.

The proposal presented on Thursday at a policy council under the Ministry of Health, Labor and Welfare would also apply to Japanese nationals' overseas family. Exceptions would include children of Japanese nationals studying abroad.

Japan's universal health insurance system requires all citizens and non-Japanese residing in the country for more than three months to enroll in either national or employer-sponsored plans. Coverage extends to family members who meet certain criteria.

This means that foreigners' dependents can be eligible for benefits even if they do not live in Japan. Under the proposed legislation, coverage would in principle be limited to family members residing in the country.

With an increase in foreign labor looming ahead of an April 1 loosening of work permit rules, lawmakers in the ruling coalition have expressed concern that this could further drive up national health care spending, which is already rising in the aging country.

The ministry aims to submit a bill incorporating the changes during the parliamentary session starting later this month, with the new eligibility rules expected to take effect on April 1, 2020.

The proposal would also give municipalities, which run the national health insurance program locally, authority to check with employers or schools on the eligibility status of non-Japanese residents. It also calls for the creation of a fund for promoting the use of electronic medical records and other digital technology in health care provision.

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