Bulk billing fell through the 2010s and early 2020s, the legacy of a six-year freeze on Medicare rebate indexation that the AMA calculates stripped $8.3 billion from Medicare. By 2023-24 the rate for GP visits had dropped to 77.3 per cent, patient out-of-pocket costs had more than doubled in three years to $1.66 billion, and the share of people delaying a GP visit on cost grounds had risen from 3.5 per cent to 8.8 per cent.

Labor's response came in two stages. From November 2023 it tripled the bulk billing incentive for pensioners, concession cardholders and children under 16, lifting the rate to 77.7 per cent by March 2024. That fixed billing for the 11 million people covered, where more than nine in ten visits are now bulk billed, but did nothing for everyone else.

The $8.5 billion expansion. Announced in February 2025 and in force from 1 November 2025, it works through two mechanisms:

• Bulk billing incentives extended to all Medicare-eligible patients. Around 45.5 million GP services a year that previously attracted no incentive now do. The incentive is weighted by location, from $25.70 in inner metropolitan areas to $49.45 in the most remote.

• The Bulk Billing Practice Incentive Program (BBPIP). Practices where every doctor bulk bills every patient receive a quarterly loading of 12.5 per cent of MBS benefits earned, split evenly with the GP.

Together these take the total Medicare payment for a standard metropolitan bulk billed consultation from $42.85 to $69.56, and up to $84.86 in rural and remote areas. A further $600 million funds 2,000 GP trainee places a year by 2028 and 400 nursing scholarships. The Coalition matched the package dollar for dollar.

Outcomes. The first quarter produced the largest jump in bulk billing in 20 years outside the pandemic, to 81.4 per cent. Growth then flattened, at 81.9 per cent in the March quarter, before rising again to 84.1 per cent in the June 2026 quarter, against 79.2 per cent a year earlier. Every state and territory rose:

• Northern Territory 90.8 per cent, up 13 percentage points

• New South Wales 87.5 per cent, up 4.1 percentage points

• Victoria 85.7 per cent, up 5.7 percentage points

• South Australia 82.5 per cent, up 6 percentage points

• Queensland 82 per cent, up 4.7 percentage points

• Tasmania 80.8 per cent, up 5.5 percentage points

• Western Australia 76.8 per cent, up 4.8 percentage points

• Australian Capital Territory 59.3 per cent, up 2.4 percentage points

The 16 to 64 cohort, the group the reform was designed for, grew fastest, up 8.2 percentage points to 78.6 per cent. Registered bulk billing practices reached 3,819 by 30 June 2026, up from around 1,600. The Office of Impact Analysis had set a success metric of 3,600 practices within two years; that was passed in six months.

Trade-offs. The reform lifts the return on bulk billing without changing the underlying rebate, and the RACGP has been consistent that this is its limit. President Dr Michael Wright argues the pressing problem is the rebate for longer and complex consultations, where the college wants a 40 per cent increase and an independent pricing authority. Neither the 2025-26 nor 2026-27 Budget changed indexation.

For patients still paying a gap, the average out-of-pocket rose from $51.89 to $61.30, largely because low-fee clinics are the ones converting to full bulk billing. Averaged across all GP services including bulk billed ones, the cost to patients fell from $11.87 to $11.02. The ACT remains a clear outlier at 59.3 per cent, and the 2026-27 Budget put $25.3 million into up to six government-funded bulk billing clinics in the Hunter and Central Coast, a market intervention the RACGP has criticised as distorting rather than fixing the funding problem.

Where it stands. The rate is 8.5 percentage points above where it was before Labor started investing. Reaching the 2030 target of nine in ten visits bulk billed needs a further 5.9 points over roughly four years, which Butler said in August 2026 he remains confident of. Three quarters of data is not yet a trend, but it does establish that GP billing decisions respond to the financial return, and that the response is largest where the incentive is largest.

Key Figures

• $8.5 billion to expand bulk billing incentives

• 84.1 per cent national bulk billing rate, up from 75.6 per cent

• 3,819 registered bulk billing practices, against a target of 3,600 by 2028

• $69.56 Medicare payment for a standard metropolitan bulk billed consultation, up from $42.85

• 12.5 per cent BBPIP loading, split evenly between practice and GP

• $859 million a year in projected patient savings by 2030

Sources

1. Strengthening Medicare: Bulk billing on the up, Department of Health, 10 August 2026

2. National GP bulk billing snapshot, April to June 2026

3. Bulk Billing for all Australians, Office of Impact Analysis

4. Growth in bulk-billing rates starts to level off, newsGP, 26 May 2026

5. Budget 2026-27: A stronger care system for all Australians, 12 May 2026

[2] https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/six-million-additional-bulk-billed-gp-visits-since-governments-historic-investment#:~:text=In%20November%202023%2C%20the%20Labor,with%20kids%20and%20young%20teenagers.

[3] https://www1.racgp.org.au/newsgp/professional/general-practice-front-and-centre-this-federal-ele

[4] https://www.smh.com.au/politics/federal/bulk-billing-at-centre-of-labor-election-pitch-attack-on-dutton-20241216-p5kyl0.html

[5] https://alp.org.au/news/cheaper-medicines-and-more-bulk-billing/