Israeli Health Funds Report: Clalit's Market Share Declines Amid Rising Costs

A new report from the Ministry of Health reveals that Clalit, Israel's largest health fund, experienced a slight decrease in its market share among insured individuals in 2025 compared to 2024. Clalit now insures 50.78% of the population, down from 50.96% the previous year. When accounting for "standardized persons", a calculation that weights individuals based on socio-demographic factors for higher capitation payments, Clalit's share of the budget decreased from 52.19% to 51.88%.

In contrast, Maccabi's market share rose from 27.48% to 27.51% of insured individuals, and its standardized persons share increased from 27.8% to 28.07%. Meuhedet saw its share grow from 13.99% to 14.14% (12.58% to 12.7% for standardized persons), while Leumit's share remained stable at 7.57% (7.35% for standardized persons). This trend of Clalit's declining market share, particularly in standardized persons, has been ongoing since 2014, dropping from 55.83% to 51.88%.

Despite the market share dip, Clalit's absolute number of insured members increased due to new enrollments, including 73,000 members who switched from other funds. However, Maccabi, Meuhedet, and Leumit collectively attracted more members from Clalit than they lost to it. Clalit attributes its market share decline primarily to long-term demographic trends, noting that its historically broad coverage of the entire population means it now insures a larger proportion of the elderly, who are passing away, while younger populations in other funds are aging.

Clalit significantly reduced its deficit, reporting 364 million shekels (approximately 0.7% of its revenue) in 2025, down from 542 million shekels (1.1%) in the previous year. This deficit reduction is attributed to operational activities and income from services outside the standard basket, as well as improvements in the financial status of its public hospitals, which are typically loss-making. The Ministry of Health stated that the deficit reduction was due to routine operations and income from services outside the basket, and that the condition of the fund's hospitals has also improved.

Other health funds, while not in deficit, saw changes in their surpluses. Maccabi's surplus decreased from 189 million shekels to 11 million shekels, attributed to increased expenses in salaries, service procurement, and medical supplies. Meuhedet's surplus rose from 7 million to 53 million shekels, and Leumit moved from a balanced budget to a 6 million shekel surplus, largely due to their ownership of the private MediCare hospital chain. Overall, health funds' spending on purchasing services from hospitals increased due to a growing number of insured individuals and a trend of outsourcing services rather than developing them internally.

Total government support for health funds in 2025 reached 4.6 billion shekels, an increase from 4.1 billion shekels in 2024, primarily for mental health and general stabilization. The Ministry of Health is working to integrate these support funds into the official health basket. Despite these measures, health funds still require approximately 1.9 billion shekels in stabilization support for 2025. The report also highlights a doubling in spending on medications and medical equipment over the past decade, reaching 14.8 billion shekels in 2025, and warns of future cost increases due to new expensive drugs for rare diseases, obesity, and Alzheimer's, urging an increase in health fund budgets.