全民健康保險停復保爭議之研究【本期企劃】 試閱
A Study on the Suspension and Resumption of Coverage in National Health Insurance
本文以憲法法庭新近受理一則案件（109年度憲二字第192號）為楔子，探究國人返國復保繳納保費的課題。文中先處理全民健保制度作為生存權保障的方式，以及財務穩定性之重要性。其次從法律關係切入，分析爭議中停復保規定對人民權益的影響。其次，剖析停復保規定的合憲性爭議，先論究社會保險立法者所為制度建構時，應注意之財務原則、給付原則與其地域限定性。並接續從授權明確性、比例原則與差別對待等三點，分析相關規定對停保者、復保者、再申請停保者之合憲性議題。整體而言，歷來憲法解釋忽略健康權之制度性保障觀點；有關財產權之案例僅從特別法律保留審查。相關規定尚不至違憲，但對復保者提供給付已近似社會救助，理應考慮是否使停保者負擔一定費用。
This study investigated the resumption of Taiwan national health insurance (NHI) coverage and the payment of premiums by overseas Taiwanese upon their return based on a case recently handled by the Constitutional Court (109 Xian Er Zi No. 192). The article first addressed the importance of the NHI system as a means of protecting the right to health and importance of its financial stability. Second, the impact of the controversial regulations concerning the suspension and resumption of NHI coverage on the rights and interests of the people was analyzed from the perspective of jural relations. Furthermore, the constitutionality controversies surrounding the regulations for the suspension and resumption of NHI coverage were examined. In this regard, the principles of finance, payment, and territorial restrictiveness that should receive special attention from social insurance legislators during system construction are first discussed. Moreover, the constitutionality of relevant regulations governing those suspending, resuming, and re-applying for suspension of coverage was investigated from three angles — the principle of the explicit delegation, principle of proportionality, and differential treatment. All in all, previous constitutional interpretations have neglected the perspective of institutional guarantee of the right to health; cases in relation to property rights have been reserved for review as per special legislation. Although the relevant regulations are not unconstitutional, the benefits provided to individuals resuming coverage are tantamount to social assistance. Therefore, whether to oblige individuals suspending coverage to pay a specific amount of premiums should be considered.
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