🏥 NHI Cabinet Order Draft Open for Comment

❓ What's changing?

The National Health Insurance Division of Japan's Ministry of Health, Labour and Welfare (MHLW) has opened a public comment period on the draft Cabinet Order on arranging related Cabinet Orders in line with the partial entry into force of the Act partially amending the Health Insurance Act and other acts (case no. 495260165, category: social insurance). The draft was published on August 27, 2026, and comments are accepted from 17:00 that day until 23:59 on September 26, 2026. A Cabinet Order (seirei) sets the details that a statute delegates to the government; here, the related orders are being adjusted as the amended act takes effect in stages. The cited legal bases are Articles 35, 73(1), 73(2), 73(6), 81, and 81-2(3) and (4) of the National Health Insurance Act (Act No. 192 of 1958), Article 703-5(2) of the Local Tax Act (Act No. 226 of 1950), which sits among the National Health Insurance tax provisions, and Supplementary Provision Article 47(4)(iii) of the Act partially amending the Child and Childcare Support Act and other acts (Act No. 47 of 2024). Given that the responsible office is the National Health Insurance Division, the work centers on orders governing National Health Insurance, which municipalities and prefectures operate. This is still a draft: the text is finalized after the comment period. The procedure follows the Administrative Procedure Act, and submitters are asked to read both the comment guidelines (including where to submit) and the full draft order first.

👥 Who is affected?

• ●Foreign residents enrolled in municipal National Health Insurance (NHI / kokuho)
• ●Students, self-employed workers and freelancers who use NHI because they have no employer health insurance
• ●Heads of households that pay the National Health Insurance tax or premium
• ●Households with children who follow the framework under Act No. 47 of 2024 amending the Child and Childcare Support Act
• ●Anyone who wants to submit an opinion on this draft order (by 23:59 on September 26, 2026)

🌏 Impact on foreign residents

Foreign nationals who stay in Japan for more than three months and are registered as residents must join municipal National Health Insurance if they are not covered by an employer's health insurance. Students, self-employed workers and freelancers rely on this NHI for medical care and pay the NHI tax or premium. This draft Cabinet Order cites provisions that govern how NHI is run and how its premium/tax is handled, so once finalized it will flow into municipal practice and the notices you receive. For now it is only a draft — nothing about your insurance card or your share of medical costs changes today. Three points matter: (1) the content is fixed only after the comment period; (2) anyone can submit a comment regardless of nationality; and (3) your actual premium or tax amount, and any reduction, is decided by the municipality where you live, so check the notices from your city or ward office once the order is finalized.