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The article examines the emergence of a complementary health insurance market in France over the past twenty years. We develop the idea that, far from having followed an unambiguous trajectory, this evolution results from the convergence of series of partially independent reforms: the European “insurance” and “Solvency II” directives; the development of managed care, encouraged by the public authorities; and more recently, the obligation for private sector companies to provide complementary coverage to their employees. While each reform contributes to the strengthening of market for complementary health insurance, we insist on the fact that they respond to different logics and mobilize specific actors. In this context, the article shows the tensions induced by this multiplicity of “marketization” processes, which results in a more complex regulation of complementary health insurance in the French system.