Regimul contribuției de asigurări sociale de sănătate între aparența proporționalității și realitatea inechității
The Health Insurance Contribution Regime Between the Appearance of Proportionality and the Reality of Inequality

Summary/Abstract: This article offers an in‑depth legal and fiscal analysis of the health insurance contribution (CASS) regime applicable to liberal professions in Romania. It highlights structural inequities resulting from rigid thresholds, which are fixed limits that determine the eligibility for certain benefits or the application of certain rules. In the context of the CASS regime, these rigid thresholds often lead to inequities by setting income or profit limits that do not reflect the actual financial situation of liberal professionals. The analysis, conducted with thoroughness and attention to detail, is complemented by a comparative perspective on systems in the European Union, where most member states apply proportional schemes directly linked to net income and ensure equitable access to services. The Romanian model, in contrast, is regressive and capped and indirectly favours high earners while penalising middle‑income or seasonal liberal professionals, providing a reliable and comprehensive understanding of the CASS regime. The study also examines the legal implications of the current framework through the lens of constitutional principles of proportionality (Art. 56), equity, and non‑discrimination (Art. 16), as well as potential violations of EU law regarding the freedom to provide services (Art. 49‑56 TFEU). In conclusion, the article proposes concrete reform proposals that promise significant benefits regarding fairness, legal neutrality, and fiscal sustainability, offering a hopeful vision for the future of the CASS regime.

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