While the idea of capping health insurance costs failed at the ballot box on the national level, a similar proposal is now set to be voted on in Zurich. Here’s what you need to know about the Premium Relief Initiative in the largest city in Switzerland.

Zurich to vote on plan to cut health insurance premiums

At the end of September 2023, the Social Democratic Party (SP), alongside the Greens and Unia trade union, submitted the "To relieve the population of rising health insurance premiums" or Premium Relief Initiative in Zurich. The proposal called for an increase in subsidies for basic health insurance in the city.

Though they leave it up to local authorities to decide how to enforce the plan, the SP called for subsidies of between 250 and 500 francs a month per person, and for 60 million francs to be spent on the programme every year. In addition, the proposal would extend premium subsidies to all individuals living in Zurich with an income of 60.000 francs a year or less, and couples with a combined annual salary of 100.000 francs or less.

If this sounds familiar, it’s because Switzerland has already been to the ballot box to vote on lower insurance premiums in the last year. The national Premium Relief Initiative, which would have capped premiums at 10 percent of a person’s income nationwide, was rejected by 56 percent of voters on June 9, 2024.

Zurich council accepts the "thrust" of the proposal

Nevertheless, speaking to the Neue Zürcher Zeitung (NZZ), Zurich SP president Oliver Heimgartner argued that the current system of premium relief in Zurich is “completely inadequate”. He noted that health insurance premiums, which have risen significantly for three years in a row, remain a heavy financial burden for both low and middle-income earners.

In a statement released at the end of February 2025, the city council said it “supports the thrust” of the proposal. “The cost of living in the city of Zurich is high, especially rent and health costs,” authorities wrote, adding that rising health insurance costs remains one of the biggest worries among residents.

“Average premiums have more than doubled since the introduction of the current Health Insurance Act in 1997. Because health insurance premiums are per capita premiums, this places a heavy burden on families and people with low incomes in particular,” they noted. The council added that while premium subsidies were meant to cushion rising costs, they have failed to keep up as the cost of healthcare has risen faster than wages and overall inflation.

How would Zurich's counter-proposal affect health insurance costs?

However, they also conceded that the 60-million franc price tag is far too high and therefore submitted a counter-proposal - a plan that would be enacted if the Premium Relief Initiative is rejected. Under this plan, more targeted relief totalling 20 million francs a year would be given to families with children. In addition, lawmakers would be able to reduce subsidies depending on the city’s financial situation.

Speaking to the NZZ, FDP city official Marita Verbali called for the main proposal to be rejected, arguing that it would be doubling up on the relief low-income families receive through other forms of social assistance. She added that by holding the vote, Zurich was disregarding the national referendum held in 2024.

As to the chances of the proposal succeeding, the last local attempt to reduce health insurance costs in Zurich was rejected by voters in 2021. Though it will be on the ballot, the date of the referendum is yet to be revealed.