The Board of Directors of the National Fund for Social Security Organizations (CNOPS) has approved the unreserved certification of the AMO Public Sector accounts for 2023. The board emphasized the importance of protecting the acquired rights of insured individuals and CNOPS employees amid upcoming AMO reforms.

During its 28th session, chaired by Miloud Massid, the CNOPS board also adopted the 2023 financial and activity reports. These reports highlighted significant achievements in procedure simplification, digitalization, data exchange with partners to improve service access, and ongoing efforts to combat fraud, notably through the nationwide software “CNOPS360.” This tool tracks insured and healthcare provider consumption to prevent fraud.

The external auditor has certified the AMO Public Sector accounts without reservation for the tenth consecutive year since 2014. This certification extends to the AMO student regime and the agreement between CNOPS, the state, and the National Human Rights Council to cover former victims of severe human rights violations from 1956 to 1999, as well as the common sector and mutualist clinic accounts.

Key financial indicators

The AMO Public Sector covered 3.111 million beneficiaries in 2023, with insured contributions totaling 6.31 billion dirhams (MMDH), up 3% from 6.12 MMDH in 2022. Despite this slow contribution growth, benefits payments rose to 7.45 MMDH in 2023 from 5.86 MMDH in 2022, a 27% increase.

Since the AMO’s inception in 2005, CNOPS has disbursed 79 MMDH, making it the primary financier of medical coverage in Morocco. However, the 2023 gap between contributions and payments resulted in a 1.28 MMDH deficit. This follows deficits of 878 MDH in 2022 and 1.51 MMDH in 2021, forcing CNOPS to withdraw 1.6 MMDH from its security reserves to meet its obligations, risking reserve depletion by 2027.

Contributing factors to financial imbalance

The financial challenges stem from continuous expansion of the healthcare basket, particularly costly medications, high prices for medicines, medical devices, biological analyses, and dental care. Delays in approving reimbursement caps for ceramic-metal crowns, weak cost control measures, capped contributions, and unchanged rates since 2005 also contribute to the imbalance.

Additionally, the rising number of long-term and costly illness cases, which accounted for 3.7 billion dirhams (53% of expenditures) in 2023, the aging insured population (retirees increased from 20.8% in 2006 to 38.4% in 2023), and the claims rate increase from 51.6% in 2022 to 52.9% in 2023 exacerbate the situation.

Urgent call for reforms

The CNOPS board urged the authorities to take immediate action to ensure the sustainability of the AMO Public Sector and restore its financial balance. They also reviewed the draft law on AMO regime fusion, expressing concerns over the lack of consultation with CNOPS and the Mutuelles, which have jointly managed AMO and complementary coverage for 74 years.

Miloud Massid emphasized CNOPS and Mutuelles’ commitment to the royal project of universal AMO and their determination to leverage their long-standing expertise to uphold citizens’ dignity and their constitutional right to healthcare access. He criticized the exclusion of CNOPS and Mutuelles from the reform process, arguing it contradicts the participatory principle in Law 21-09 on social protection and the constitutional role of the mutual sector.

The CNOPS board called on the government to protect the acquired rights of the insured and safeguard CNOPS and Mutuelles employees amid the ambiguities of draft law 54-23 on AMO regime fusion. They also urged authorities to expedite the approval of the CNOPS employee status, last revised in 2011, to prevent further loss of human resources to other social protection institutions.

In conclusion, CNOPS and the Mutuelles reaffirmed their commitment to contributing to the success of the royal project for universal AMO and ensuring its sustainability through their expertise, experience, and dedication to social solidarity and protecting insured individuals’ rights.