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

Mr REPACHOLI (Hunter) (12:49): Let's not beat around the bush. Let's be up front about what the Private Health Insurance Amendment (Modernising the Private Health Insurance Rebate) Bill actually does. It makes a difficult but necessary choice about where taxpayers' money can do the most good.

Do we continue paying an additional private health insurance rebate purely on somebody's age, or do we put nearly $3 billion more into aged-care beds, more Support at Home places and better dementia care? We've chosen to invest in care. This bill will bring the rebate for Australians aged 65 and over into line with the income based systems that apply to everybody else.

Right now, two people can earn the exact same income and hold the exact same private health insurance but receive different rebates simply because one has turned 65. That doesn't make much sense to me. Under this bill, the support somebody receives will be based on their income, not their birthday.

Let me be absolutely clear about what this bill doesn't do. It doesn't abolish the private health insurance rebate, it doesn't take away anyone's private health insurance and it doesn't stop older Australians from using the private health system. People on lower and middle incomes will continue to receive substantial government assistance.

A single person earning $101,000 or less will still receive a rebate of around 24 per cent on their premium. That support is not disappearing. The change will begin on 1 April 2027.

The average impact is expected to be around $250 per person per year. That is less than a dollar a day. I'm not going to stand here and pretend people will be happy about paying more.

Household budgets are tight. Private health insurance is already a significant expense, and every extra cost does matter. But governing means making choices about where public money will make the greatest differences.

This decision will raise nearly $3 billion over four years, and that money will be invested directly into aged care. It will help build more residential aged-care beds. It will provide more Support at Home places.

It will reduce waiting times, improve specialist dementia care and help older Australians stay in their own homes for longer. That's the choice before this parliament. Of course, the coalition have immediately reached for their usual playbook.

They're going straight to the scare campaign, and shame on you all on that side! They want older Australians to believe they'll lose their private health insurance, they want people to believe private health membership will collapse, they want people to believe public hospitals will suddenly be overwhelmed and they want Australians to believe that this government is attacking older people.

That is absolute rubbish, and you need to have a good hard look at yourselves. Government modelling shows private health insurance membership will continue to grow overall. The estimated reduction resulting from this measure is around 0.4 per cent, or approximately 44,000 people.

That's a long way from the collapse being predicted by those opposite. Some people may change their cover, but many would have chosen to use the public system anyway. The expected impact on the public hospital demand is minimal.

The coalition know that, but the facts don't suit their political scare campaign, so they choose to ignore them. They would rather frighten older Aussies than have an honest conversation about how we fund aged-care services that this country desperately needs. Frankly, I'm sick of hearing those opposite talk about Australians using public hospitals as if they're doing something wrong.

Aussies are entitled to use Medicare. They're entitled to receive treatment in public hospital. They've paid taxes and contributed to this country throughout their whole working lives.

They're not a second-class citizen, because they don't have private health insurance. Labor believes your Medicare card, not your credit card, should determine whether you receive health care or not. We're backing that belief with record investment.

We're investing $8½ billion to strengthen Medicare and expand bulk-billing. By the end of the decade that investment is expected to deliver another 18 million bulk-billed GP visits every year, with nine out of 10 GP visits expected to be bulk-billed. That matters right across the Hunter but also right across this beautiful country.

It matters to the pensioner in Cessnock who needs regular appointments to manage diabetes or heart disease. It matters to the older couple in Kurri Kurri who are watching every dollar and shouldn't have to put off seeing their doctor because they're worried about costs. For older Aussies, going to the GP isn't something that happens once or twice a year.

It can mean regular appointments, prescriptions, blood tests, referrals, care plans and follow-up visits. If those costs start piling up, people put appointments off. A small problem becomes a big problem.

A condition that could have been managed by a GP becomes an emergency. Bulk-billing saves people money, but it also helps them receive care earlier and stay healthier for longer. That's why our investment in Medicare matters.

We are also expanding the Medicare urgent care clinic network. Medicare Urgent Care Cessnock gives locals another option when they need urgent medical attention but don't need a hospital emergency department. There are also clinics in Charlestown, Lake Haven and Maitland.

They're fully bulk-billed. You don't need an appointment. You can walk in and receive care for things like minor fractures, infections, cuts requiring stitches and sprains.

Think about what that means for an older person in Cessnock. Instead of finding someone to drive you to Maitland Hospital or the John Hunter, then sitting in the emergency department for hours, they can receive that care closer to home. It's better for the patient and easier for their families, and it takes pressure off our emergency departments so doctors and nurses can concentrate on the most serious of cases.

We're also making medicines cheaper. The maximum PBS co-payment for general patients has been reduced to $25. The concession price has been frozen at $7.70 until 2030.

Sixty-day prescriptions are saving eligible patients time and money for an older Aussie taking several regular medications, those savings add up. They mean fewer trips to the pharmacy and less money coming out of the household budget. We're also delivering record public funding for hospitals.

From 2026-27 to 2029-30, the Australian government will contribute $168.7 billion for public health and hospital services under the National Health Reform Agreement. That funding backs the doctors, nurses, paramedics and health professionals who care for Aussies every single day in this country. It supports public hospitals Hunter residents depend on, including Maitland, Cessnock and John Hunter.

So, when the coalition claims Labor is abandoning older Australians, people really should have a look at the full record. More bulk-billing, more Medicare, urgent care clinics, cheaper medicines, record public hospital funding, more aged-care beds, more Support at Home, better dementia care, better wages for aged-care workers—that's Labor's record. What's the coalition's record, I hear you ask.

It is a decade of underinvestment, delay and neglect. They were warned repeatedly that aged care was in crisis. Reports gathered dust.

Providers struggled. Workers were underpaid and undervalued. Families waited too long for help at home.

Older Australians remained in hospital because there was no appropriate aged-care place available for them. The Royal Commission into Aged Care Quality and Safety exposed a system that was understaffed, underfunded and failing too many people who built this country. The coalition had nearly a decade to fix this, but guess what.

They didn't. Now they want Aussies to forget all of that. They want to lecture us about aged care while opposing funding needed to rebuild it.

They demand more beds, more workers, more home-care places and shorter waiting lists, but, the moment the government makes a serious decision to pay for those services, they launch a scare campaign. That isn't leadership; it's political cowardice. You can't rebuild aged care with a press release.

You can't pay workers with slogans or build thousands of new beds by shouting across the chamber. You can't repair a system after a decade of neglect without investing serious money. This measure will help deliver an additional 5,000 residential aged-care beds every year through targeted capital subsidies and changes to the accommodation supplement for supported residents.

It gives providers greater certainty to build new facilities and expand existing ones. When there aren't enough aged-care beds, the impact is felt right across the healthcare system. An older person who's medically ready to leave hospital may have nowhere suitable to go.

That's not good for them or their family, and it means that that bed is not available for another patient. Building more aged-care beds is also an investment in our public hospitals. This bill also provides more support for older Australians who want to stay in their homes for longer.

And let's be honest, that is what most people want. They don't want to leave their home they've lived in for decades or more or move away from their family, their neighbours, their local doctors and their community. People in the Hunter don't want to be forced out of towns like Cessnock, Singleton or Morisset because they cannot get the support they need at home.

They may need help to shower safely. They may need help preparing meals. They may need assistance when cleaning, with mobility or to get to other medical appointments.

Sometimes a relatively small amount of practical support can be the difference between somebody remaining independent and having to enter residential care. That's what Support at Home is designed to deliver. The government has listened to concerns during the rollout and made changes where they were needed.

We changed the treatment of showering services so that, alongside clinical care, they are provided free of charge. We will continue to monitor the program and fix problems when they arise. We will also invest more than $200 million in 20 additional Specialist Dementia Care Program units and expand the Hospital to Aged Care Dementia Support Program.

Dementia affects the person diagnosed but also their entire family. Finding the right care can be incredibly difficult, particularly when somebody has complex needs. This investment will provide more specialised care and help people living with dementia move from hospital into an appropriate residential setting.

That will give families greater certainty, provide better care for the individual and free up hospital capacity for other patients. We're also backing the aged-care workforce. For years, aged-care workers were expected to perform demanding skills and deeply important work without receiving the pay or recognition that they deserved.

These are the people helping our parents and our grandparents through some of the most vulnerable moments in their lives. Labor supported substantial wage increases for aged-care workers because good aged-care depends on attracting and keeping good people. The coalition talks about respecting older Australians.

We're funding the workers who actually care for them. It's a pretty simple principle behind this bill. A 64-year-old and a 66-year-old earning the same income should receive the same rebate.

Someone's financial circumstances should determine the government assistance that they receive, not the date on their birth certificate. Private health insurance will continue to play an important role in our healthcare system. The government will continue working on improving its affordability and value.

But we can't ignore the desperate need for more investment in aged care. Those opposite have every right to oppose this decision, but they should have the guts to explain their alternative. If they oppose this measure, which aged-care beds should we not build?

Which Support at Home places should we actually cut? Which dementia units should not go ahead? Which families should be waiting longer?

Which older Australians should remain in hospital because an appropriate aged-care place is not available? They can't demand more aged-care funding while opposing every responsible decision required to pay for it. They can't spend a decade neglecting aged care and then pretend it's there to be its greatest defender.

And they shouldn't frighten older Australians by making claims they know are not supported by evidence. Older Australians deserve better than another dishonest political scare campaign. They deserve strong Medicare, well-funded hospitals, affordable medicines and an option to remain at home with the proper support.

When residential aged care is needed, they deserve a safe place close to family and close to community. This bill maintains substantial income based assistance for private health insurance, while directing nearly $3 billion into aged care. That's $3 billion into more beds, more care at home, better dementia services and greater dignity for older Australians.

And you know where that really matters the most? It's not just the older Australians; it's their family members, friends and communities, who actually care what happens to those older Australians. They actually care about aged care, the support older Australians need and the help that they are going to get in staying at home longer or in going out and being in those aged-care facilities.

So I really hope those opposite actually choose to stop the scare campaign and actually get behind this, because the scare campaign is scaring older Australians for no reason. You guys should be ashamed of yourself. I commend this bill to the House.