2025-05-222024/25:SoU27 · p.1SoUHealth & social services
Government's Legislative Proposal
The government's bill on an updated cost-cap for medicines
What's at stake: The bill means that the state's share of medicine costs decreases while the patient's out-of-pocket fee increases. This particularly affects low-income pensioners, people with chronic illnesses and people with disabilities, who risk higher costs for essential medicine, while the system is meant to be able to absorb future, expensive new medicines without crowding out other welfare spending.
Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.
What the vote decides
The reservation wanted to reject the government's bill to amend the Act on pharmaceutical benefits, while the committee held that the bill is needed to make the distribution of costs sustainable in the long run and that Parliament should therefore adopt it.
Yes Yes — the committee proposal
The committee shares the government's assessment that, without adaptation, state costs will keep rising in an unsustainable way that risks reducing access to new medicines or crowding out other welfare spending. The bill, in the committee's view, improves the ability to distribute costs sustainably over the long term while still protecting those with the greatest need for medicine against excessive costs, and Parliament should therefore adopt it.
No No — the reservations
Reservation 1 (S, V, MP)
The reservation (S, V, MP) is critical of the government's handling of the update, considers the bill poorly thought through and at risk of hitting low-income pensioners, the chronically ill and people with disabilities hard, especially at a time of economic crisis for Swedish households, and therefore wants Parliament to reject the government's bill.
Summarised from the committee report. Party labels in the summary come from the report, not from the vote.
What do the votes mean here?
Yes The committee proposal: adopting the government's legislative proposal and rejecting the motions (keeping things as they are).
No Backing the counter-proposal: reservation 1 by S, V, MP.
Abstain The party marks a position of its own that is not one of the two final alternatives.
What each plan points to — and how the party voted
For each party: the vote its own election manifesto and party programme point to in this case, next to how the party actually voted. A plan can only point to Yes or No; a party can also abstain.
| Plan | Vote | Confidence | Evidence | ||
|---|---|---|---|---|---|
| V | No | No 0/18/0/6 | follows the plan | confidence: high | derived |
| S | No | No 0/89/0/17 | follows the plan | confidence: medium | derived |
| MP | No | No 0/14/0/4 | follows the plan | confidence: high | derived |
| C | No | Yes 21/0/0/3 | departs from the plan | confidence: medium | derived |
| L | No | Yes 11/0/0/5 | departs from the plan | confidence: medium | derived |
| KD | No | Yes 15/0/0/4 | departs from the plan | confidence: medium | derived |
| M | Yes | Yes 58/0/0/10 | follows the plan | confidence: low | derived |
| SD | No | Yes 63/0/0/9 | departs from the plan | confidence: medium | derived |
Committee proposal
Parliament adopts the Government's proposal for a law amending the law (2002:160) on pharmaceutical benefits etc. Thereby Parliament grants proposition 2024/25:144 and rejects the motions 2024/25:3358 by Karin Rågsjö et al. (V), 2024/25:3369 by Fredrik Lundh Sammeli et al. (S) and 2024/25:3380 by Nils Seye Larsen et al. (MP) request 1.
Original (Swedish)
Riksdagen antar regeringens förslag till lag om ändring i lagen (2002:160) om läkemedelsförmåner m.m. Därmed bifaller riksdagen proposition 2024/25:144 och avslår motionerna 2024/25:3358 av Karin Rågsjö m.fl. (V), 2024/25:3369 av Fredrik Lundh Sammeli m.fl. (S) och 2024/25:3380 av Nils Seye Larsen m.fl. (MP) yrkande 1.
Riksdag decision: Parliament approved the Government's proposal to increase the co-payment within the cost cap. The proposal means that the cost limit for the co-payment is raised from 2 900 kronor to 3 800 kronor, that is, patients themselves will bear a larger share of the cost before the cost cap takes effect. At most, the patient's costs increase by 900 kronor. The cost ladder within the cost cap is also raised and provides that: Patients must pay the entire pharmaceutical cost up to 2 000 kronor, compared with today's 1 450 kronor. The first step is changed so that the patient bears 75% of the cost instead of today's 50%. The law enters into force on 1 July 2025.
Counter-proposals
- The counter-proposal wants to reject the government's proposal to update the high-cost protection for medicines. (S, V, MP) — Reservation 1
Plan vs actual vote
Every party, in chamber order: what its own plan pointed to, how it voted, and the reasoning behind both. Highlighted rows are where the two differ — but a vote that follows the plan is a result too, so the reasoning is there for every party.
The plan establishes that the costs of care and medicines must be affordable for all and that needs, not the wallet, should determine access to care.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan establishes that the costs of care and medicines must be affordable for all and that needs, not the wallet, should determine access to care. A raised deductible that risks hitting hard against low-income pensioners, chronically ill and people with disabilities contradicts this and the plan's criticism of growing inequality in access to care. The weak economic situation strengthens that assessment.
Original (Swedish)
Planen slår fast att kostnaderna för vård och läkemedel ska vara överkomliga för alla och att behoven, inte plånboken, ska styra tillgången till vård. En höjd egenavgift som riskerar att slå hårt mot låginkomstpensionärer, kroniskt sjuka och personer med funktionsnedsättning strider mot det och mot planens kritik av växande ojämlikhet i tillgången till vård. Det svaga konjunkturläget förstärker den bedömningen.
- affordable medicine costsdecisive»Kostnaderna för vård och läkemedel ska vara överkomliga för« (party programme ↗)“The costs of care and medicines must be affordable for”
- needs should determine care»Behoven ska styra, du ska inte behöva lösa en privat försäkring för att få en bra sjukvård och tandvård eller en trygg förlossning.« (2022 manifesto ↗)“Needs shall determine, you should not have to solve a private insurance to get good healthcare and dental care or a safe childbirth.”
- unequal care access»Ojämlikheten i tillgång till hälso- och sjukvård har« (party programme ↗)“Inequality in access to healthcare has”
- dignified old age»I ett av världens rikaste länder, Sverige, måste det gå att ha ett gott liv även som äldre.« (2022 manifesto ↗)“In one of the world's richest countries, Sweden, it must be possible to have a good life even as an elderly person.”
Worldstate weighed in: GDP indicator falls 1.5 percent year-on-year — households' margins are pressured, which sharpens the plan's requirement for affordable care costs; Unemployment is at 8.0 percent — more people with low incomes are affected by a raised deductible
The election manifesto promises targeted support to those hardest hit by price increases and particularly points out pensioners with low pensions and persons with disabilities.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto promises targeted support to those hardest hit by price increases and particularly points out pensioners with low pensions and persons with disabilities. A raised self-pay in the pharmaceutical benefit hits precisely low-income pensioners and the chronically ill. The party programme states that access to care must not be determined by ability to pay. The plan therefore supports the counter-proposal's objection.
Original (Swedish)
Valmanifestet lovar riktat stöd till dem som drabbas hårdast av prisökningarna och pekar särskilt ut pensionärer med låga pensioner samt personer med funktionsnedsättning. En höjd egenavgift i läkemedelsförmånen träffar just låginkomstpensionärer och kroniskt sjuka. Partiprogrammet slår fast att tillgången till vård inte får avgöras av betalningsförmåga. Planen stöder därför motförslagets invändning.
- protect the most vulnerabledecisive»Stöd till de som drabbas hårdast av prisökningarna.« (2022 manifesto ↗)“Support for those hardest hit by price increases.”
- low pensions shall be raised»Alltför många pensionärer som har arbetat ett helt yrkesliv, särskilt kvinnor, har för låga pensioner.« (2022 manifesto ↗)“Far too many pensioners who have worked a whole career, particularly women, have too low pensions.”
- care according to need»Skola, vård och omsorg har en central roll för fördelningen av möjligheter i livet.« (party programme ↗)“School, health care and care have a central role in the distribution of life opportunities.”
- protection for people with disabilities»Personer med funktionsnedsättning ska kunna leva sitt liv som andra.« (2022 manifesto ↗)“People with disabilities shall be able to live their lives like others.”
The election manifesto establishes that those with the least resources shall get more public services and more support and wants to broaden the high-cost protection, among other things to aids and dental care.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The election manifesto establishes that those with the least resources shall get more public services and more support and wants to broaden the high-cost protection, among other things to aids and dental care. The party programme requires care that is solidarity-financed and distributed according to need where the chronically ill are not left behind. Increased co-payments that hit low-income pensioners and the chronically ill go against this.
Original (Swedish)
Valmanifestet slår fast att de med minst resurser ska få mer samhällsservice och mer stöd och vill bredda högkostnadsskyddet, bland annat till hjälpmedel och tandvård. Partiprogrammet kräver en solidariskt finansierad vård fördelad efter behov där kroniskt sjuka inte får stå tillbaka. Höjda egenavgifter som slår mot låginkomstpensionärer och kroniskt sjuka går emot detta.
- those with the least resources are protecteddecisive»De med minst resurser ska få mer samhällsservice, lägre skatt och mer stöd i omställningen.« (2022 manifesto ↗)“Those with the least resources shall get more public services, lower tax and more support in the transition.”
- care according to need»Vården ska hålla god kvalitet, vara tillgänglig, fördelas efter behov och vara solidariskt finansierad.« (party programme ↗)“Care shall be of good quality, be accessible, be distributed according to need and be solidarity-financed.”
- the chronically ill are prioritized»Vårdgarantier bör därför utgå från medicinska behov och ersättningarna i sjukvården baseras på patienternas vårdtyngd, så att inte friska människor prioriteras framför kroniskt sjuka.« (party programme ↗)“Care guarantees should therefore be based on medical need and reimbursements in health care be based on patients' care intensity, so that healthy people are not prioritized over the chronically ill.”
- broader high-cost protection»att hjälpmedel ska ingå i högkostnadsskyddet.« (2022 manifesto ↗)“that aids shall be included in the high-cost protection.”
Worldstate weighed in: Unemployment at 8.0 per cent and GDP indicator -1.5 per cent — Weak business cycle strengthens the plan's requirement to protect households with small margins against increased co-payments.
The party programme establishes that care in the publicly financed healthcare system shall be given according to need and not according to ability to pay, and the election manifesto wants to mitigate the worst effects of cost pressure for those with small margins.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The party programme establishes that care in the publicly financed healthcare system shall be given according to need and not according to ability to pay, and the election manifesto wants to mitigate the worst effects of cost pressure for those with small margins. A raised out-of-pocket cost that hits low-income pensioners, chronically ill and people with disabilities goes against these commitments. The plan's requirement for economy with public funds weighs lighter when it comes to cost protection for the sickest.
Original (Swedish)
Partiprogrammet slår fast att vård i den offentligt finansierade sjukvården ska ges efter behov och inte efter betalningsförmåga, och valmanifestet vill mildra kostnadstryckets värsta effekter för dem med små marginaler. En höjd egenavgift som slår mot låginkomstpensionärer, kroniskt sjuka och personer med funktionsnedsättning går emot dessa åtaganden. Planens krav på hushållning med skattemedel väger lättare när det gäller just kostnadsskyddet för de sjukaste.
- care according to needdecisive»att snabbt få vård i den offentligt finansierade sjukvården ska ges efter behov och inte efter betalningsförmåga.« (party programme ↗)“to quickly receive care in the publicly financed healthcare system shall be given according to need and not according to ability to pay.”
- protect those with small margins»För att möta detta krävs insatser som mildrar inflationens värsta effekter för dem med små marginaler.« (2022 manifesto ↗)“To meet this requires measures that mitigate the worst effects of inflation for those with small margins.”
- security for pensioners»Sveriges pensionärer ska ha god trygghet, nu och många år framöver.« (2022 manifesto ↗)“Sweden's pensioners shall have good security, now and many years to come.”
- support for disability»Du som har en funktionsnedsättning ska få det stöd du behöver, och staten ska ta ett större ansvar för att LSS fungerar.« (2022 manifesto ↗)“You who have a disability shall get the support you need, and the state shall take greater responsibility for LSS to work.”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan establishes that care and social services mainly shall be financed through tax and that care shall be equal regardless of economic status, and the election manifesto wants patients to gradually pay less and society more.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan establishes that care and social services mainly shall be financed through tax and that care shall be equal regardless of economic status, and the election manifesto wants patients to gradually pay less and society more. A raised patient fee that affects low-income pensioners and chronically ill goes in the opposite direction. The plan therefore speaks for the counter-proposal's objection.
Original (Swedish)
Planen slår fast att vård och omsorg i huvudsak ska betalas över skattsedeln och att vården ska vara jämlik oavsett ekonomi, och valmanifestet vill att patienten steg för steg betalar mindre och samhället mer. En höjd egenavgift som slår mot låginkomstpensionärer och kroniskt sjuka går i motsatt riktning. Planen talar därför för motförslagets invändning.
- care financed through taxdecisive»Vård och omsorg ska i huvudsak betalas över skattsedeln och ska alltid« (party programme ↗)“Care and social services shall mainly be financed through tax and shall always”
- patient shall pay less»Tandvårdens finansiering ska steg för steg likna annan sjukvård där du som patient betalar mindre och samhället mer.« (2022 manifesto ↗)“Dental care financing shall gradually resemble other health care where you as a patient pay less and society more.”
- equal care regardless of economic status»Vården ska vara jämlik. Var och en har rätt till god vård och omsorg oavsett bakgrund, kön, ålder,« (party programme ↗)“Care shall be equal. Everyone has the right to good care and social services regardless of background, gender, age”
- strengthened pensioner income»Vi vill fortsätta stärka Sveriges pensionärers inkomster så att det alltid lönat sig att ha arbetat.« (2022 manifesto ↗)“We want to continue to strengthen the income of Sweden's pensioners so that it has always been worthwhile to have worked.”
Worldstate weighed in: Unemployment 8.0 per cent and negative GDP indicator — Sharpens the plan's requirement that cost protection must not hit those with the least margin
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan lays down that it must never become an economic question whether one can obtain the care and support one needs, and that charges must be structured with this as the starting point.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan lays down that it must never become an economic question whether one can obtain the care and support one needs, and that charges must be structured with this as the starting point. Medicines must be covered by a solidarily financed system. A change that risks striking hard against low-income pensioners and chronically ill persons goes against this, and the party also wants to raise the guaranteed pension and lower the cost ceiling for dental care.
Original (Swedish)
Planen slår fast att det aldrig får bli en ekonomisk fråga om man kan få den vård och omsorg man behöver, och att avgifter ska utformas med detta som utgångspunkt. Läkemedel ska omfattas av ett solidariskt finansierat system. En förändring som riskerar att slå hårt mot låginkomstpensionärer och kroniskt sjuka går emot detta, och partiet vill dessutom höja garantipensionen och sänka högkostnadsskyddet inom tandvården.
- care independent of walletdecisive»Det får aldrig bli en ekonomisk fråga om man ska kunna få tillgång till den service, vård och omsorg man behöver. Avgifter ska utformas med detta som utgångspunkt.« (party programme ↗)“It must never become an economic question whether one should be able to obtain access to the service, care and support one needs. Charges must be structured with this as the starting point.”
- solidarily financed medicines»Läkemedel ska efter särskilt godkännande omfattas av ett solidariskt finansierat system.« (party programme ↗)“Medicines must, after special approval, be covered by a solidarily financed system.”
- lowered cost ceiling»Stärkt tandvård för äldre bland annat genom att sänka högkostnadsskyddet för tandvård.« (2022 manifesto ↗)“Strengthened dental care for the elderly among other things by lowering the cost ceiling for dental care.”
- strengthened finances for pensioners»Höjd garantipension och höjt bostadstillägg för pensionärer.« (2022 manifesto ↗)“Raised guaranteed pension and raised housing supplement for pensioners.”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan states that policy must prioritize and eliminate, and that the major needs in the justice system, defence and welfare place hard demands on prioritization.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan states that policy must prioritize and eliminate, and that the major needs in the justice system, defence and welfare place hard demands on prioritization. The party programme particularly warns that welfare's core mission is hollowed out when the commitment constantly grows. To stop a reform that is to distribute medicine costs more sustainably in the long term runs counter to that direction, even though the plan simultaneously wants to protect pensioners' finances.
Original (Swedish)
Planen slår fast att politiken måste prioritera och välja bort och att de stora behoven inom rättsväsende, försvar och välfärd ställer hårda krav på prioriteringar. Partiprogrammet varnar särskilt för att välfärdens kärnuppdrag urholkas när åtagandet ständigt växer. Att stoppa en reform som ska fördela läkemedelskostnaderna mer långsiktigt hållbart går emot den linjen, även om planen samtidigt vill värna pensionärernas ekonomi.
- prioritize and choose to eliminatedecisive»Politiken har en viktig uppgift att prioritera och välja bort,« (party programme ↗)“Policy has an important task to prioritize and choose to eliminate,”
- tough prioritization»De stora behoven inom rättsväsendet, försvaret och välfärden ställer stora krav på prioriteringar under åren som kommer.« (2022 manifesto ↗)“The major needs in the justice system, defence and welfare place major demands on prioritization in the years to come.”
- welfare cannot always be expanded»Ett långsiktigt hot mot den svenska välfärden är föreställningen om att den befinner sig i ett ständigt pågående skede« (party programme ↗)“A long-term threat to Swedish welfare is the belief that it finds itself in a constantly ongoing construction phase”
- protect pensioners' finances»Sänka skatten för alla Sveriges pensionärer« (2022 manifesto ↗)“Lower the tax for all Sweden's pensioners”
The election manifesto establishes that poverty among the elderly shall be abolished, wants to increase financial support to the most vulnerable elderly and to those who due to illness or disability have not been able to work.
Plan documents: 2022 manifesto
Reasoning and quotes
The election manifesto establishes that poverty among the elderly shall be abolished, wants to increase financial support to the most vulnerable elderly and to those who due to illness or disability have not been able to work. Public funds shall be focused on the heart of the welfare state. The counter-proposal's objection that an increased out-of-pocket fee hits low-income pensioners and the chronically ill is therefore in line with the plan.
Original (Swedish)
Valmanifestet slår fast att äldrefattigdomen ska avskaffas, vill öka det ekonomiska stödet till de mest utsatta äldre och till dem som på grund av sjukdom eller funktionsnedsättning inte kunnat arbeta. Offentliga anslag ska fokuseras på välfärdens hjärta. Motförslagets invändning att en höjd egenavgift slår mot låginkomstpensionärer och kroniskt sjuka ligger därför i linje med planen.
- support for vulnerable elderlydecisive»Öka det ekonomiska stödet till de mest utsatta äldre« (2022 manifesto ↗)“Increase financial support to the most vulnerable elderly”
- abolished elderly poverty»Äldrefattigdomen ska avskaffas.« (2022 manifesto ↗)“Poverty among the elderly shall be abolished.”
- support for sick and disabled»Samtidigt behövs ett ökat stöd till de mest utsatta, som på grund av sjukdom eller funktionsnedsättning inte har kunnat arbeta i full utsträckning.« (2022 manifesto ↗)“At the same time, increased support is needed for the most vulnerable, who due to illness or disability have not been able to work fully.”
- prioritization of the heart of the welfare state»Offentliga anslag ska i första hand fokuseras för att stärka välfärdens hjärta genom höjda pensioner och medel som säkerställer att polis, sjukvård, skola och omsorg oavsett var i landet man bor.« (2022 manifesto ↗)“Public appropriations should primarily be focused on strengthening the heart of the welfare state through increased pensions and funds that ensure that police, healthcare, school and care regardless of where in the country you live.”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
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Sources and documents
- The committee report on riksdagen.se (2024/25:SoU27)
- Committee report full text (HC01SoU27)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2024/25:3358 — med anledning av prop. 2024/25:144 Uppdaterat högkostnadsskydd för läkemedel av Karin Rågsjö m.fl. (V)
- Motion 2024/25:3369 — med anledning av prop. 2024/25:144 Uppdaterat högkostnadsskydd för läkemedel av Fredrik Lundh Sammeli m.fl. (S)
- Motion 2024/25:3380 — med anledning av prop. 2024/25:144 Uppdaterat högkostnadsskydd för läkemedel av Nils Seye Larsen m.fl. (MP)
- Proposition 2024/25:144 — Uppdaterat högkostnadsskydd för läkemedel
Source: The Swedish Parliament