Russia’s Healthcare Budget Hole Is Growing—And Its Reserves Are Almost Gone

Russia’s mandatory health insurance system is projected to accumulate a funding deficit of about $4.56 billion over the next three years as federal healthcare support is reduced, The Moscow Times reported on November 4.

The projected shortfall is contained in a draft budget for The Federal Compulsory Medical Insurance Fund  (FCMIF), which the State Duma  approved in its first reading last week.

In 2027, the fund is expected to record a deficit of about $2.06 billion. The shortfall is projected at roughly $956 million in 2028 and $1.55 billion in 2029, according to The Moscow Times.

The deficit is expected to force FCMIF to draw down nearly all of its available cash reserves. The fund currently holds about $4.52 billion in bank accounts, but only around $1.9 million is projected to remain by 2029.

“That means that by the end of the three-year period, the source will be practically exhausted,” Andrey Ragozin, director of a healthcare financing research center at the Financial University under the Russian government, told Medvestnik .

Federal transfers to FCMIF are set to fall 23% next year, from about $5.88 billion to $4.55 billion. Overall federal healthcare spending is projected to decline 3% to approximately $22.23 billion, The Moscow Times wrote.

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Some medical programs face considerably steeper cuts. Funding for cancer treatment programs is set to fall from about $549 million to $46 million, while spending on healthcare infrastructure is projected to decline from roughly $941 million to $665 million.

Russia’s total government healthcare spending remains at 3.6% of GDP, according to Guzel Ulumbekova, head of the Higher School of Healthcare Organization and Management. That remains below the 5–6% level recommended by the World Health Organization, The Moscow Times reported.

Russia’s healthcare cuts come amid broader reductions in civilian spending across the country. In October, Ukraine’s Foreign Intelligence Service reported that 65 Russian regions were preparing to cut investment, repairs, and infrastructure spending for 2027–2029 as war-related expenditures and growing obligations strained local budgets.

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