Private Health Insurance Amendment (Modernising the Private Health Insurance Rebate) Bill 2026

Ms BRISKEY (Maribyrnong) (12:11): In 2004, the Howard government looked at the private health insurance rebate and made it bigger—not for everyone, of course, but for Australians aged 65 and over and for them alone. It was an election year. Our economy was riding a global resources boom and revenue was arriving faster than the government of the day knew what to do with it.

In weather like that, you never have to choose. You can simply add. So they added.

They drew a line at a birthday and they wrote a bigger cheque to everyone on one side of it. It wasn't argued for; it wasn't modelled against the purpose of the rebate; it didn't come out of any considered view about what older Australians would need as they aged. It came in a year when there was money on the table and a government that wanted to get re-elected.

That was 22 years ago. For over half of that time those opposite sat on the government benches. In every single one of those years, the line stayed exactly where it was.

It didn't stay there because it was a defensible policy. It stayed because taking it away would have been unpleasant. It was much easier to put it in the too-hard basket and let someone else deal with it later.

Well, our government is capable of making hard decisions. The bill before us, the Private Health Insurance Amendment (Modernising the Private Health Insurance Rebate) Bill 2026, does one thing. It returns the rebate for Australians over 65 to the same rate that every other Australian receives, including those with chronic illnesses and including those going through cancer treatment.

From 1 April 2027, the rebate will be calculated the same way for a 70-year-old as it is for a 40-year old. It will stay means-tested, of course. It will stay higher for people on lower incomes.

Age stops being the thing that decides it. Here is what the current arrangement actually looks like on a street in my electorate. Two houses next door to each other have the same financial situation, the same policy and the same insurer.

One household gets a larger contribution from the Commonwealth than the other, and the only difference between them is the year that they were born. I've spent a fair bit of time trying to rationalise the argument for that, and I can't get there. Very few people, being genuine, can.

That is why nobody has tried in 22 years. They have simply hoped another government would come along and do it for them—or, in the case of those opposite, they preferred to maintain the status quo of inequity. It gets harder still when you look at how private health insurance already works in our country.

Under community rating, everybody pays the same premium for the same policy. Your health status doesn't change it and your age doesn't change it, which means younger policyholders are already carrying a share of older policyholders' claims, and they are doing it quietly, every month, without complaint. The rebate then goes back on top of that and hands the larger share to the same group again.

Like so many of the economic settings John Howard is responsible for, it destabilised the playing field and tilted it against younger generations. There's one more thing that makes it indefensible. The rebate exists to encourage people to take up private cover in the first place.

Older Australians are the group most likely to hold private health insurance and to keep holding it. We are paying a premium price for a decision people are already making. My community is home to 26,100 Australians over 65.

That's about 17 per cent of my community, well above the state average. About 7½ thousand of them are over 80, which again sits above the state average—and so does our dementia rate. Plenty of them hold private health insurance, and they have held it for decades.

A lot of them took it out the moment they could afford it, in the years when affording it took some doing, and they've kept paying, through every premium rise since. They keep it under this bill. In my electorate—and I spoke about this just the other day—14 per cent of people provide unpaid care to someone with a disability, with a health condition or because of their age.

Victoria's figure is just under 13 per cent, and the national figure is just under 12. My community carries more of this than most places across the country. There are people in my electorate who are somewhere in their 50s, working, raising kids who are not quite out of home and driving to their parents' place four or five nights a week to look after them.

They are the ones who cook the meals, sort the medications and sometimes help their parents shower because their loved one can't do it safely on their own anymore and the package hasn't come through yet. Her mother has held private health insurance for 35 years, gold cover—never missed a payment. That gap gets filled by families.

It always has been. Those carers have been sidelined by those opposite in this rebate debate entirely. For me and our government, they are part of the reason we are making this hard decision.

The Commonwealth spends about $8 billion a year on the private health insurance rebate. That is a very large amount of money, and this government continues to spend it because keeping private cover affordable does take real pressure off our public hospitals. That case is sound, and there is no intention of walking away from it.

But $8 billion a year is a choice, and the shape of it is a choice. Every dollar spent on an age based top-up that brought no additional take-up was a dollar not spent on the aged-care system that our older Australians reach eventually—every one of them, whether they have cover or not. We have made the hard decision.

The $3 billion this measure saves goes straight into aged care. It delivers an additional 5,000 residential aged-care beds a year through targeted capital subsidies, and it changes the accommodation supplement for supported residents. More importantly, it gives providers the certainty they need to actually build accommodation and to maintain it properly once it is built.

It puts more Support at Home packages into the system and gets them out faster. Waiting for a package can be awful. It goes beyond inconvenience.

I think of the families in my community and how they do so much unpaid care four or five nights a week and for months longer than they should need to. We have already responded to what people have told us about that program. Showering services through Support at Home are now free of charge, alongside clinical care.

Personal dignity should not be an optional extra with a co-payment attached. There is over $200 million for 20 additional Specialist Dementia Care Program units and an expansion of the Hospital to Aged Care Dementia Support Program. My community has an above-average dementia rate and an ageing population, and I have families in Maribyrnong navigating that right now, with very little underneath them.

All of it eases pressure on our public hospitals too, because an older person stuck in a hospital bed waiting for an aged-care place is a bed no-one else can use. I'll deal with the two objections that will come and that are already coming, because I'd rather answer them than have them shouted at me. The first is that this drives older Australians out of private cover.

The modelling says otherwise. The number of insured Australians over 65 keeps growing. By 2028-29, there are expected to be about 45,000 fewer people over 65 with cover than if we'd changed nothing.

That's 0.4 per cent in a sector that is growing two per cent a year. That's five times the change in the opposite direction. The second is that this abandons older Australians.

It does not. Australians over 65 keep a government subsidised discount of 24 per cent of their premiums, exactly as every other Australian on their income does. They keep the community rating.

They keep indexation of the rebate, which this government restored, whereas those opposite froze it. While we're here, I note that the rebate is means tested because a previous Labor government introduced that test in 2012. Those opposite fought us on it.

Then they governed for nine years and kept every cent of it, because they knew perfectly well we were right. The best argument for this bill is the one those opposite have been making by omission for 22 years. They have never defended the age based rebate on the merits.

They've only ever defended it for their own political purposes, as they so often do. That perfectly highlights their time in government and their approach to the decisions that were sitting in the too-hard basket. The easy thing is available to all of us here today.

I could stand here and say nothing, let it pass and hope that the letters land in somebody else's office, and I would probably get away with it. But my community has 26,100 people over the age of 65 and over 7,500 over the age of 80, and the number of older Australians in my community is going up, not down. What they will need is not a slightly better rebate on a hospital policy; it's a bed in a good home near their family, without having to wait; a package that arrives while they can still use it; or someone to help them shower who is paid properly and has the time to do it kindly.

That is what the $3 billion can be better spent on, and it is why this difficult decision is the right one. That is why this government has made the decision those opposite spent 22 years avoiding, because, when it comes to building a dignified aged-care system that values older Australians and cares for them, it is only those on this side of the House who are committed to improving the systems of inequality in order to ensure better and fairer outcomes.

I commend the bill to the House.