Rabat – A new study by Bank Al-Maghrib (BAM) has shed light on the limits of Morocco’s current social protection architecture, calling for a broader assessment of its social impact and macroeconomic consequences.
According to the central bank’s analysis, while Morocco’s health coverage rate exceeded 85% in 2022, households continue to shoulder a disproportionate share of medical costs.
Data from the National Health Accounts show that 38% of total health expenditure is still paid directly by families, far above the 25% threshold recommended by the World Health Organization (WHO), beyond which health spending is deemed a driver of vulnerability.
The rate also surpasses the MENA regional average (26%) and that of upper-middle-income countries (31.7%). These figures expose a structural imbalance between nominal health coverage and actual financial protection.
BAM’s researchers warn that despite nearly two decades of reform, the system’s fragmentation and limited accessibility continue to undermine its intended impact.
Coverage expanding but still uneven
The study outlines Morocco’s multi-tiered health coverage system, which includes AMO-CNSS for private sector workers, CNOPS for public employees, AMO-Tadamon for vulnerable groups, AMO Achamil for voluntary enrollees, and complementary private or institutional schemes.
While this structure has widened coverage, it has failed to ensure uniform protection. In 2022, out-of-pocket household spending reached MAD 31 billion ($3 billion), averaging roughly MAD 848 ($83) per person.
This financial burden weighs heavily on rural and low-income families, limiting their capacity to invest in essentials such as education, housing, or food. As a result, health insurance is still perceived as partial, unreliable, and often inaccessible.
Health insurance and financial behavior
A key finding of BAM’s study is the relationship between health coverage and household saving behavior. Drawing on nationally representative data, the report finds that access to health insurance correlates with a notable decrease in precautionary savings, particularly among vulnerable households.
Once protected from unexpected medical costs, families redirect their income toward other needs, basic consumption for lower-income groups, and education or housing improvements for wealthier ones.
However, the report cautions that a structural decline in savings could pose risks to financial stability. A lower national savings rate can affect investment capacity, interest rate dynamics, and resilience to economic shocks.
A call for a holistic approach
BAM’s study urges policymakers to adopt a more comprehensive view of social reform outcomes. Expanding health coverage, it argues, should not be assessed solely by enrollment numbers but by its impact on household spending, consumption, and investment.
The report recommends integrating these behavioral shifts into macroeconomic models and designing policies that better reflect families’ real financial trade-offs.
The authors stress that the quality of coverage remains decisive. If essential care remains costly or difficult to access, households will continue to save out of fear rather than confidence.
To make health insurance a true driver of economic and social progress, Morocco must reduce out-of-pocket expenses, improve healthcare access in rural areas, and streamline the complexity of public schemes.
Ultimately, BAM’s study invites a deeper reflection on the coherence between Morocco’s social ambitions and the financial realities facing its citizens.
