Brussels Governance MonitorHealth COCOM: INAMI budget 41.3 Bn, e-Health 2026-2029, EDC card
The 2026 INAMI health budget reaches 41.3 Bn EUR (+2%). The e-Health 2026-2029 plan has been published. Iriscare issued 5,871 European Disability Cards in 2025. COCOM still needs to relaunch accreditations, agreements and the homelessness plan.
Unblocked mechanisms — awaiting implementation
These mechanisms were frozen during the caretaker government period (June 2024 – February 2026). The government sworn in on 14 February 2026 can now reactivate them.
Accreditation of new care facilities
No new care facility (nursing home, day centre, home care service) could be accredited by COCOM under the caretaker government. The new government can now unblock these accreditations.
Refinancing of Iriscare agreements
Multi-year agreements between Iriscare and care providers that had expired could not be renewed or revalued. The new government can now relaunch them.
Homelessness plan
The structural plan to combat homelessness could not be adopted or funded beyond the existing winter emergency scheme. The new government can now launch it.
Mental health initiatives
No new mental health initiative (mobile teams, reception centres, prevention programmes) could be launched. The new government can now launch new initiatives.
What continues
Iriscare day-to-day operations
Iriscare continues to carry out its core missions: paying care providers, managing existing accreditations, inspections, processing individual files.
Bruss'Help counts
Bruss'Help continues its periodic counts of homeless people and the operational coordination of the sector.
Winter emergency scheme
The winter emergency shelter scheme is maintained each year, funded from recurrent budgets.
Impact indicators
on provisional twelfths
COCOM budget
COCOM/GGC
9,777
Homeless or without a home
Bruss'Help (8th count, November 2024)
0
New health accreditations issued
Iriscare
several months
Mental health waiting lists
Brussels mental health network
308,000+
Children receiving family allowances
Famiris / COCOM
41.3 Bn EUR
INAMI health care budget (2026)
INAMI / Le Spécialiste (2026)
5,871
European Disability Cards issued (2025)
Iriscare (Feb. 2026)
Government agreement: announced impacts
According to concordant press sources, the agreement of 12 February 2026 includes several measures that affect the bi-communal health and social sector:
- Administrative reform (merger of pillars): the merger of 25 regional bodies into 3 to 4 entities could affect the governance of COCOM and Iriscare. The precise terms are not yet known
- Regional drugs commissioner: this new role, announced under the security chapter, intersects with COCOM's competences in harm reduction and addiction care
- Budgetary effort: the trajectory to return to balance by 2029 implies an expenditure review that also concerns COCOM's budgets, which are already operating on provisional twelfths
Key consideration: the end of the caretaker period makes it possible to unblock accreditations, Iriscare agreements and the structural plan to combat homelessness. The scale of this relaunch will depend on upcoming budgetary arbitrations.
Federal and regional developments (February 2026)
INAMI budget 2026: 41.3 billion EUR
The INAMI General Council approved the 2026 health care budget at 41.297 billion EUR, an increase of 1.566 billion corresponding to the 2% growth norm + indexation. This budget covers:
- 150M EUR in medical services management
- 50M EUR for hospitals
- 228M EUR in pharmaceutical savings
- 47M EUR in savings from other providers
Hospitals benefit from improved cash flow: 580M EUR in accelerated payments in 2025, 275M EUR expected in 2026.
Source: Le Specialiste, "le budget des soins de sante 2026 approuve par le Conseil general de l'INAMI".
e-Health plan 2026-2029
The FPS Public Health published a new e-Health action plan covering the period 2026-2029, focused on the digital management of health data. This plan applies to the entire territory, including Brussels.
Source: FPS Public Health, e-Health action plan 2026-2029.
European Disability Card
Iriscare issued 5,871 European Disability Cards (EDC) to Brussels residents in 2025 (announced on 10 February 2026). This card facilitates access to services and discounts throughout the EU.
Source: Iriscare, press release of 10 February 2026.
PFAS: Health Dimension
PFAS contamination raises health concerns. TFA (trifluoroacetic acid) is detected in all 6 Brussels drinking water reservoirs. Dutch health authorities report potential effects on the liver and immune system, although an independent scientific council considers the risk 'unlikely'. The Environment Council calls for an integrated framework including the health dimension.
Source: RTBF / Brussels Environment, 2024-2026.
ACS in the Health-Social Sector
The ACS mechanism funds a significant portion of staff in home care services, early childhood care and elderly care. The freeze on positions since 2007 and the lack of refinancing weigh on the sector's capacity to meet growing demand. The non-profit sector demonstration of 3 February 2026 highlighted this structural tension.
Source: Actiris / non-profit sector, 2026.
Iriscare approvals were frozen, conventions not renewed and the homelessness plan stalled. Zero new approvals between June 2024 and February 2026, with waiting lists of several months for mental health care.
Read full contextBack to home — 2 March 2026
Follow this topic by email
Max. 1 email/week. Unsubscribe in 1 click.