Home care, ball in the stands: urgent request rejected

Context

TL;DR

• Ticino rejects urgency to remove home care cost-sharing
• Cost-sharing set at 10 francs/day, max 300 francs/year
• Measure affects Lugano, Bellinzona, and Locarno
• Cross-border workers face increased home care costs

Key facts

• Decision Date: April 1, 2024
• Daily Cost: 10 francs per day
• Annual Cap: 300 francs per year
• Affected Cities: Lugano, Bellinzona, Locarno
• Cross-Border Impact: 10-20% cost-sharing for cross-border workers
• Annual Users: Approximately 12,000 people per year
• Average Annual Cost: 5,000 francs per patient
• Signature Count: Over 20,000 signatures collected

The Grand Council of Ticino has rejected the urgency request on the initiative that asked to remove the cost-sharing by patients for home care. The decision was made with 41 votes in favor and 38 against, but a two-thirds majority was needed. The parliamentary initiative had been presented by the Socialist group leader Ivo Durisch and co-signatories, and requested the removal of cost-sharing by users of care services.

The measure, included in the 2026 Budget and entered into force on April 1st, has sparked strong opposition, with over 20,000 signatures collected in a few days. The cost-sharing for home care, known as 'spitex', has been set at 10 francs per day for a maximum of 30 days per year, with a maximum annual cap of 300 francs. This measure has particularly affected the municipalities of Lugano, Bellinzona, and Locarno, where the demand for home care services is higher.

Reactions to the Decision

The Socialist group leader, Ivo Durisch, stated that voting on the urgency also meant voting 'no' to a certain mode of communication to the Grand Council. He added that if the government wants to propose it again, it should do so with transparent data and a real parliamentary debate, not through a regulation.

Deputy Fabrizio Sirica defined the measure as 'hidden in the Budget', while Maurizio Canetta called on everyone not to hide behind the technicality of urgency. Marco Noi spoke of 'schizophrenia' and Matteo Pronzini summarized the situation with an 'A mistake was made'.

Among those in favor of the urgency, also the Lega dei Ticinesi, with Andrea Sanvido stating that penalizing spitex, which represents less than 5% of the total expenditure, risks being not only unfair but also counterproductive.

Concrete Examples and Impacts

In Ticino, the spitex service is used by approximately 12,000 people per year, with an average annual cost of 5,000 francs per patient. The new measure has resulted in increased costs for families, with a significant impact on those with lower incomes. For example, a patient in Lugano who uses the service for 30 days a year will now have to pay 300 francs, an amount that can be unsustainable for many families.

Operational Checklist

For patients and families using the spitex service, it is important to know the following points:

• Daily cost: 10 francs per day.
• Maximum days of use: 30 days per year.
• Annual cap: 300 francs.
• Exemptions: Possible for cases of indigence or particular situations.

Comparisons Between Practical Scenarios

Before the measure came into force, a patient who used the spitex service for 30 days a year had no cost to bear. Now, with the new regulation, the same patient will have to pay 300 francs annually. This cost increase can influence the decision of many families to resort to alternative services or to reduce the use of the service.

Regulations and Dates

The measure was introduced with the 2026 Budget and came into force on April 1st, 2024. The Grand Council's decision to reject the urgency request means that the measure will remain in force until it is modified or abolished.

Conclusion

The Grand Council's decision has sparked many reactions, both positive and negative. While some see the measure as a way to contain costs, others consider it unfair and counterproductive. The discussion continues, and it will be interesting to see how the situation evolves in the coming months.

Operational details

Practical Implications for Cross-Border Workers

The decision by the Ticino Grand Council has important implications for cross-border workers residing in Ticino and using home care services. The measure, which came into effect on April 1, 2026, involves a cost-sharing component for users, meaning cross-border workers will have to cover part of the costs for home care. According to the new regulations, patients will contribute an amount ranging from 10% to 20% of the total cost of the services, depending on income and family situation.

Comparison with the Previous Situation

Before the measure came into effect, the costs of home care were fully covered by the public healthcare system. With the new regulations, patients will have to contribute to the costs, which could result in increased expenses for cross-border workers using these services. For example, a cross-border worker residing in Mendrisio who receives home care for a family member might have to pay up to 500 francs per month, depending on the type of assistance required.

Possible Scenarios

If the measure is confirmed, cross-border workers might face additional costs for home care. This could lead to a reduction in the use of these services, with potential repercussions on the quality of life for patients. Furthermore, the measure could be seen as a penalty for the most vulnerable, as highlighted by Deputy Fabrizio Sirica.

Operational Checklist

For cross-border workers using home care services, it is important to follow a series of steps to better understand the new provisions:

1. Income Verification: Determine your annual income to calculate the percentage of cost-sharing. 2. Documentation: Gather all necessary documentation, including identity documents and medical certificates. 3. Contact the Municipality: Reach out to your municipality of residence for detailed information on procedures and specific costs. 4. Financial Planning: Assess your financial resources and plan for any additional expenses.

Comparison of Practical Scenarios

Let's consider two practical scenarios to better understand the impact of the new regulations:

• Scenario A: A cross-border worker residing in Lugano with an annual income of 60,000 francs and a family member requiring home care for 20 hours per week. With the new regulations, they might have to pay approximately 300 francs per month.
• Scenario B: A cross-border worker residing in Bellinzona with an annual income of 80,000 francs and a family member requiring home care for 10 hours per week. In this case, the monthly cost could be around 200 francs.

📊 Data and Figures

According to data from the Department of Health and Social Affairs of the Canton of Ticino, approximately 15% of cross-border workers use home care services. With the introduction of the new regulations, it is estimated that the number of users could decrease by 10-15%, significantly impacting the quality of life of the most vulnerable individuals.

💡 Practical Tips

To mitigate the financial impact of the new regulations, cross-border workers can consider various options:

• Private Insurance: Evaluate the possibility of taking out private insurance that covers part of the costs for home care.
• Public Subsidies: Inform yourself about the public subsidies available for low-income families.
• Family Planning: Involve other family members in the management of home care to reduce costs.

⚠️ Warnings

It is important to note that the new regulations could have a significant impact on families with lower incomes. Cross-border workers should therefore carefully plan their expenses and seek to obtain all necessary information to avoid financial surprises.

Recommended tools

For an updated estimate, use the net salary calculator and the CHF-EUR exchange comparator.

Key points

What to Do Now

While awaiting further developments, cross-border workers who use home care services should closely monitor the situation and stay informed about any changes in regulations. It is advisable to consult your doctor and your health insurer to better understand how the new measure might affect your medical expenses.

📊 Concrete example: A cross-border worker residing in Mendrisio who uses home care services for a family member might face additional costs if the regulations change. Currently, the cost-sharing for home care is set at 10% of the total cost, with a maximum of 1,000 francs per year. If this threshold were removed, costs could increase significantly.

💡 Operational checklist:

• Verify with your doctor the home care services you need.
• Contact your health insurer to understand current and future coverage.
• Use the healthcare cost calculator to estimate current and future costs.
• Consider the opportunity to change health insurance if costs were to increase.

Useful Tools

To get a clearer idea of the financial implications, cross-border workers can use the healthcare cost calculator available on the Frontaliere Ticino website. This tool allows you to estimate the costs of healthcare services and better plan your finances.

📊 Concrete example: A cross-border worker residing in Lugano who uses home physiotherapy services might discover that current costs are approximately 80 francs per session. With 20 sessions per year, the total cost would be 1,600 francs. If the cost-sharing increased to 20%, the cross-border worker would have to pay 320 francs instead of the current 160 francs.

Additionally, you can consult the health insurance comparator to find the coverage best suited to your needs and budget.

💡 Comparison of practical scenarios:

• Current scenario: Cost-sharing of 10% with a maximum of 1,000 francs per year.
• Future scenario (hypothetical): Cost-sharing of 20% with no maximum cap. A cross-border worker who currently pays 1,000 francs might have to pay 2,000 francs or more.

Conclusions

The decision of the Grand Council to reject the urgent request on the initiative to remove cost-sharing for home care has raised many questions and concerns. Cross-border workers who use these services should remain vigilant and informed about any changes in regulations. Using tools such as the healthcare cost calculator and the insurance comparator can help better manage your finances and plan for the future.

⚠️ Attention: Current regulations allow cross-border workers residing in Ticino to benefit from home care services with a cost-sharing of 10%, but this situation could change. It is crucial to stay updated and prepare for possible increases in costs.

"The decision of the Grand Council was made to ensure the sustainability of the healthcare system, but it is important that cross-border workers are aware of the possible financial consequences." — A representative of the Ticino Department of Health.

Source: tio.ch