Labor’s health insurance cuts threaten access to Australia’s most common surgery

The Australian Society of Ophthalmologists (ASO) has joined National Seniors Australia’s escalating campaign against the Labor Government’s proposed cuts to private health insurance rebates for Australians aged over 65, warning the policy risks pricing older Australians out of essential healthcare and driving more patients into an already overstretched public system.

Backing National Seniors Australia’s Health Costs campaign, the ASO is urging older Australians to scrutinise the government’s proposal and is supporting calls for an independent inquiry into the private health system.

At the centre of the controversy is the plan to reduce the higher Private Health Insurance rebate currently available to Australians aged 65 and over as part of funding aged care reforms. The proposal, which is currently before the Senate, is scheduled to take effect from 1 April 2027. For some couples with Gold cover, the change could increase annual out-of-pocket premiums by more than $1,000, forcing thousands of seniors to downgrade or abandon private health cover altogether.

The scale of the policy’s reach became clearer during recent Senate Estimates hearings, where Celia Street PSM, Deputy Secretary, Systems Strategy Group at the Department of Health, confirmed that 3.1 million Australians aged over 65 would be affected by the proposed changes. Yet government officials were unable to satisfactorily explain how many of those impacted were pensioners or low-income seniors when pressed by Opposition Health Minister Senator Anne Ruston.

“How can you possibly model the impact on the most vulnerable in our community if you don’t know who they are?” Senator Ruston challenged officials. “Have you bothered to engage with National Seniors Australia on this policy? How many other policy changes has the department of health made where they have not directly considered the impact on vulnerable Australians?”

Among Australians aged over 65, 42.2% hold Gold-tier private health insurance while a further 41.2% have Silver-tier cover. Gold cover underpins access to many sight-saving procedures, including cataract surgery, which is the most common elective (planned) surgery performed in Australia.

The ASO warns that if rising premiums force seniors out of private health insurance, many will face the choice of paying significantly higher out-of-pocket costs or joining lengthy public hospital waiting lists, delaying treatment at a time when preserving vision is often critical.

“For an older Australian waiting on cataract surgery, private cover can be the difference between having the procedure now and losing months of clear sight in a public queue,” said ASO CEO Katrina Ronne. “Making that cover more expensive for over-65s puts vision and the independence that comes with it directly at risk. We’re standing with National Seniors to say don’t lose sight of our seniors.”

National Seniors Australia CEO Chris Grice said the organisation has heard from pensioners and low-income self-funded retirees increasingly worried about how they will absorb higher healthcare costs while continuing to contend with persistent cost-of-living pressures.

“Older Australians have paid premiums for decades, in some cases their whole working lives. Now, when they really need that insurance – when affordability is paramount – it has been swept from under their feet,” Grice said.

The ASO said its greatest concern is that older Australians will begin delaying or avoiding treatment altogether because of escalating insurance costs.

“Ophthalmologists see every day what happens when eye care is delayed,” Ronne added. “We’d urge every older Australian to check how this change could affect them, and to add their voice to the campaign before any decision is locked in.”

Grice argued the government’s proposal risks shifting costs rather than solving them.

“NSA believes a more balanced approach is needed. One that protects older Australians, maintains access to timely care, and avoids unintended costs elsewhere in the system,” Grice added. “We encourage older Australians to support our Health Costs campaign and to help NSA increase our weight and impact. The bigger our numbers, the louder our voice!”

As pressure mounts on the government’s proposal, National Seniors Australia has launched a Private Health Insurance rebate cut estimator, allowing older Australians to calculate how the proposed changes could affect their own premiums, while continuing to push for an independent inquiry into the private health system.

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