Belgium Ends Homeopathy Reimbursement in Health Overhaul

Belgian Health Minister Frank Vandenbroucke has proposed a sweeping reform of the country’s health insurance fund system that would end reimbursement for homeopathy and acupuncture while imposing stricter financial controls, performance-based funding, and mandatory mergers on Belgium’s historically pillarized mutualities. The proposal, presented on May 19, 2026, represents the most significant overhaul of the country’s health insurance landscape in decades.

According to VRT NWS, the core of the reform requires health insurance funds (ziekenfondsen/mutualités) to demonstrate that all supplementary benefits have a clear link to health, well-being, or social objectives. Homeopathy and acupuncture — treatments with limited scientific backing for most conditions — were explicitly cited by Vandenbroucke as therapies that would no longer qualify.

Context: A System Under Pressure

Belgium’s health insurance system is organized around historically “pillarized” non-profit mutualities linked to political and ideological movements — Christian, Socialist, Liberal, and Independent. These organizations administer mandatory health insurance funded through social security contributions while also offering supplementary benefits ranging from extra reimbursements to youth camps and ski holidays.

The reform comes after months of intense pressure from coalition partner N-VA, which has been highly critical of the mutualities’ oversight of long-term sick leave beneficiaries. A RIZIV (National Institute for Health and Disability Insurance) sample audit revealed that approximately 25% of long-term sick leave recipients received benefits improperly or for too long, as VRT NWS reported.

Beyond Homeopathy: The Full Scope of Reform

While the proposed end to homeopathy and acupuncture reimbursement has captured headlines, the reform extends far deeper. Knack reports several key pillars:

Financial restructuring: Mutualities will face a cap on excess profits. Reserves above a certain solvency ratio must be returned to members via lower premiums or reinvested in health initiatives.

Performance-based funding: Starting in 2027-2028, up to 15% of mutualities’ funding will be tied to measurable health outcomes — vaccination rates, return-to-work success, and screening participation. “The era of non-commitment is over,” Vandenbroucke said.

Mandatory mergers: By July 1, 2028, only one mutualiteit per region per national union may remain. Provincial funds must consolidate into larger entities.

Digitalization mandate: Billing periods must shrink from two years to six months, and mutualities must become data-driven, transparent organizations.

Conflict-of-interest ban: Mutualities can no longer hold financial stakes in commercial organizations, and staff cannot sit on boards of for-profit health-sector entities.

Political Dynamics and Reactions

The reform tests Belgium’s fragile federal coalition. Vandenbroucke, a socialist (Vooruit), is advancing changes that N-VA, the nationalist right-wing coalition partner, has long demanded. As RTBF notes, the proposal has not yet been formally negotiated with coalition partners or approved.

N-VA MP Frieda Gijbels welcomed the direction but pushed for more. “The opaque financing of health insurance funds, the intertwining with other interests, the dual roles — those are situations that are no longer of this time,” she told Knack.

The mutualities themselves reacted with cautious openness but warned of operational risks. Luc Van Gorp, chair of the National Intermutualist College, acknowledged the need for evolution while cautioning that certain elements “risk causing problems for operations and threaten to hinder the provision of important services to our members.”

What’s Next

The proposal must still be negotiated within the coalition government before any parliamentary approval. An independent scientific commission is expected to be established by mid-2027 to evaluate all supplementary benefits against health and well-being criteria — meaning the end of homeopathy and acupuncture reimbursement may be just the beginning of a broader reassessment of what Belgian health insurance covers.

Vandenbroucke insists the reform is not a cost-cutting exercise. “It’s not a savings proposal, but a reform aimed at doing better in terms of efficiency, transparency, and solidarity,” he said. With 150 million euros in administrative savings targeted by 2029 and a transformation timeline extending through the end of the decade, the coming months of negotiation will determine whether Belgium’s pillarized health system can modernize without losing its distinctive character.