On 20 September 2026 Giorgia Meloni, from the stage of Fenix, the national youth festival, announced a cap on foreign students per class and a ban on burqas and niqabs at school. The reaction started almost in real time: the opposition attacked the measure, while the principals raised a much more practical question: how is a ceiling applied if the school has to accommodate children from the neighborhood?
The next day the new healthcare tariffs came into force. They were not a secret nor had they appeared out of nowhere: they had been discussed for months and the agreement with the Regions dated back to July. The contrast, however, remains notable: on the one hand a controversy capable of setting the political debate on fire in just a few hours, on the other a tariff much less suitable for rallies, but which for some can reach the CUP coffers with a new prescription in hand.
Many first specialist visits go from 25 to 26 euros. A cardiological visit with electrocardiogram rises from 33.60 to 38 euros, a fine needle aspiration of the breast from 31.25 to 36.50. Even venous sampling earns fifty cents: from 3.80 to 4.30 euros. Oh no, the difference cannot be paid in blood.
These are some of the new maximum reference rates that came into force with the decree of the Ministry of Health and the Ministry of Economy of 7 August 2026. The revision concerns 448 outpatient specialist services and 222 prosthetic assistance codes. This does not mean that all citizens will automatically pay those amounts: exemptions, ticket caps and regional rules continue to affect the actual amount. For some non-exempt people, however, going for a visit or exam may cost something more.
The new tariffs arrive in a system in which millions of people had already begun, well before this decree, to solve the healthcare problem in the most drastic way possible: by directly giving up using it.
To complain about the cost of a visit, you must first manage to book it
In 2024, 5.8 million people, 9.9% of the population, declared that they had given up on visits or specialist checks they needed. This is what Istat found in the 2025 annual report. In 2023 they were 7.5%. Before the pandemic, in 2019, 6.3%.
The main reason is the waiting lists: in 2024 6.8% of the population gave up for this reason, compared to 4.5% the previous year. Then comes the money. 5.3% indicated economic difficulties among the reasons for giving up healthcare services. The reasons may overlap, so the percentages should not be added. However, a double difficulty remains: there are those who cannot get a visit because they wait too long and those who cannot because it costs too much. The tariff update at least succeeds in finding a place exactly between the two problems.
In the meantime, the use of the private sector is also growing. Again according to Istat, in 2024 23.9% of people fully covered the cost of the last specialist service, without insurance reimbursement. A year earlier they were 19.9%. Four percentage points in twelve months: when the public visit comes too late, the portfolio quickly acquires a new specialization.
Of course, these are data from 2024 and cannot say anything about the effects of the increases that came into force two years later. However, they say something about the terrain on which these increases, although limited and limited to non-exempt people, fall.
How much do tickets really increase?
A distinction is needed here, because simply saying that “the cost of the cardiological visit increases by 4.40 euros” would be imprecise. And the increases do not affect the entire tariff: according to the Minister of Health Orazio Schillaci, for eight out of ten services the tariffs remain unchanged. The figures set by the decree are maximum reference rates for the remuneration of services: how much the patient actually pays depends on exemptions, Region and applied ceilings.
For outpatient specialists, the Ministry of Health indicates as a general rule a ticket equal to the rate of services up to the limit of 36.15 euros per prescription, subject to exemptions and regional regulations.
So let’s take the cardiological visit with ECG: the fee goes from 33.60 to 38 euros. Where that ceiling applies, the non-exempt patient would stop at 36.15 euros and the actual increase compared to the previous 33.60 would be 2.55 euros. For fine needle aspiration of the breast the rate rises from 31.25 to 36.50 euros and here too the limit may leave out the last 35 cents.
Two euros and fifty-five. One euro. Fifty cents. Taken one at a time they seem like details. Even a waiting list, after all, is made up of one day at a time. A national average can then make any increase almost ornamental: a sum is distributed among millions of people and suddenly it seems like we are talking about the change left under the car seat.
At the CUP, however, no one pays an average. Those who are exempt pay zero. Whoever has to perform a certain service pays that. Anyone who has to do several starts adding up. And those who have already given up for economic reasons will hardly find it comforting to know that, divided by the entire population, their increase is minuscule.
Because the rates have been revised
The revision has a concrete reason. The previous 2024 tariff had been challenged and the Lazio TAR had ordered its cancellation with deferred effect, contesting the path followed to determine the amounts. The Government therefore had to redefine the tariffs through a new investigation. The 2026 Budget Law has tied 100 million euros for this year and 183 million per year from 2027 to the update, as also recalled by the decree published in the Official Journal.
According to the Conference of Regions, the overall impact of the new decree on public finances will be approximately 210.7 million euros per year: 183.1 million for outpatient specialists and 27.6 million for prosthetics. Adapting tariffs that must remunerate structures, personnel, technologies and services has a very unmysterious reason: even running a clinic costs money. Doctors, equipment and reagents, unfortunately, do not appear by summoning.
The issue becomes more delicate when a part of the adjustment meets the citizen directly at the counter. In the documentation discussed in Parliament, the 183.1 million for specialists are in fact quantified net of the increased participation through tickets. In other words, a portion of the increase falls directly on non-exempt citizens. According to estimates from the Ministry of Health reported by ANSA, we are talking about a total of around 27 million euros in additional tickets every year, with an average of 1.50 euros per year per non-exempt citizen. An average, again.
And that passage takes on a different weight next to the numbers on access to care. In the country where almost one in ten people has already given up on a necessary visit or test, a few euros can certainly be a few euros. It mostly depends on how many times you have to take them out and how many you have before going in.
First the wait, then possibly the bill
The National Health Service is based on universal access to care. Today it has to deal with a reality in which millions of people give up on services, waiting lists push towards the private sector and almost one citizen in four declares having paid entirely out of pocket for the last visit or specialist exam.
The new tariffs do not in themselves explain the difficulties of Italian healthcare. Waiting lists, staff shortages, territorial differences and growth in private spending have much deeper roots. However, the new tariff adds another small step for a part of the citizens who still manage to remain in the public sector.
The increases concern a part of the benefits. But establishing that some cost more is also a choice, and perhaps it would deserve at least the same space as a controversy over the burqa. Booking first. Then the wait. If the wait becomes too long, the private. If you manage to stay in the public, in some cases the ticket updated. Italian healthcare now offers several options. Curiously, almost all of them pass through the wallet.
