The health taxes will rather go to the IMSS

President Claudia Sheinbaum's administration has presented the Economic Package for 2026, which in theory seeks to balance public finances with social needs. The increase in health spending, driven by increased tax revenue, is notable. According to an analysis by the Center for Economic and Budgetary Research (CIEP), this increase will be largely financed by so-called "health taxes": increases in the Special Tax on Production and Services (IEPS) levied on cigarettes, soft drinks, and video games with violent content. The Ministry of Finance itself estimates that this will generate an additional 41 billion pesos, which will be allocated to health care.

According to the PEF analyzed by CIEP, total health spending for 2026 is projected at 996.528 billion pesos, an increase of 55.551 billion pesos compared to the 940.976 billion pesos in 2025, a 5.9% increase. At first glance, this seems like a positive step, especially considering that in the first year of this administration, the health sector suffered significant cuts, hence the obvious austerity in hospitals and health centers. Now, the Treasury team appears to have received clear instructions to prioritize, at least minimally, the health of Mexicans. As a percentage of GDP, the indicator increases from 2.5% to 2.6%, an additional tenth of a percentage point that reflects some intention, but is far from being presumed.

However, breaking down the numbers raises profound questions about the real priorities. The net increase in total public spending on the health sector is about 45 billion pesos (from 941 billion to 996 billion). Although this avoids further cuts, it does not close the gap with international recommendations: the World Health Organization suggests allocating 6% of GDP to health; Mexico falls short by 3.4 percentage points. This deficiency is covered by out-of-pocket expenses by families, who sacrifice other essential items to pay for consultations, medications, or hospitalizations. In a country with chronic inequalities, this perpetuates a cycle of economic vulnerability.

The most striking aspect, according to the analysis by Judith Méndez, a specialist at CIEP, is the internal distribution of these additional resources. Instead of targeting the population without social security—the most disadvantaged, representing millions without access to basic services—the bulk of the increase benefits the IMSS (Mexican Social Security Institute). This agency will see an 11% increase in its budget, equivalent to 58 billion pesos. Why prioritize the IMSS, which has other sources of funding: employer and employee contributions? This decision clashes head-on with the official discourse of reducing the inequality gap. Historically, the beneficiary population has been the most favored, and this trend is only becoming more pronounced: by 2026, only 3 out of 10 pesos spent on health care will go to the uninsured, while 7 out of 10 will be concentrated in the segment with labor coverage.

This preference is not isolated. Other social security institutions, such as ISSSTE, Pemex, Sedena, and Semar, face cuts between 3% and 5%, suggesting a deliberate concentration on the IMSS, headed by Zoé Robledo. What is the strategic rationale? It's unclear, especially when the government emphasizes equity. If the goal is to close inequalities, the extra resources should flow to those without social security, where the needs are pressing: chronic illnesses, lack of infrastructure, and collapse in public hospitals.

Another incomprehensible point is the cuts to the Ministry of Health, headed by Dr. David Kershenobich. After losing more than half of its budget in 2025, it will now suffer an additional reduction of 2.229 billion pesos, a 3.2% decrease. Despite meetings with tax authorities, the Health Department's economic team has been unable to reverse the cuts.

In contrast, some specific programs receive modest increases. The IMSS Bienestar (Mexican Social Security Institute) increased by 0.8%, from 171,206 million to 172,492 million (an increase of 1.286 billion). The State Health Contribution Fund (FASSA) increased by 0.6%, with an additional 540 million. But the largest jump is for the Salud Casa por Casa program, under the Ministry of Welfare, which nearly doubled from 2,070.8 million to 4 billion (an increase of 93.2%). Although positive, this is insufficient to cover the 16 million older adults and people with disabilities who depend on it.

In short, the 2026 budget shows a timid effort to strengthen healthcare, funded by "healthy" taxes that could promote better habits. However, by prioritizing the Mexican Social Security Institute (IMSS) and cutting key areas, it could instead perpetuate inequalities and leave critical needs unaddressed. Going forward, a greater comprehensive strengthening of public coffers—beyond IEPS revenue collection—will be required if President Sheinbaum truly wants to advance healthcare coverage, because this requires genuine financial protection for healthcare.