• Amnesty has joined campaign against what it calls 'draconian' tax measures
• The public had up to May 11 to tender views on the proposed regulations
Thousands of Kenyans have signed a petition demanding the Ministry of Health withdraw the proposed NHIF regulations 2023, which were published this month.
The regulations will double contributions by jobless Kenyans aged 18 from Sh500 to Sh1,000.
Jobless people currently contribute Sh500 monthly but are most of the time unable to pay.
“A contributor who is not employed or listed as an indigent person or vulnerable person shall pay a monthly contribution of one thousand shillings,” clause 13 of the proposed regulations says.
A petition initiated by rights group Amnesty Kenya notes several clauses of the regulations are not only draconian but will simply impoverish Kenyans.
“We cannot let these harmful clauses go unchallenged,” Amnesty said in the petition, which will be presented to Health CS Susan Nakhumicha and board chair of the National Health Insurance Fund Michael Kamau this week.
“Access to healthcare is a human right that should not be denied or restricted by punitive clauses in legislation,” Amnesty added.
The oft-cited Sh300 contribution is only reserved for employed people, where 2.75 per cent of their gross income would fall below Sh300.
“A contributor shall pay Sh300, where the amount in paragraph (1) is less than Sh300,” the bill says.
Paragraph One of the regulations refers to the new 2.75 per cent of the declared or assessed gross monthly income of the contributor, one of the highest rates in the world.
It will also be difficult to prove you should contribute Sh300 because “the [NHIF] board may require the contributor to avail such evidence and documentation as the board may consider necessary”.
Amnesty said in total, there are 13 clauses that will limit access to affordable, quality healthcare.
The other clauses include denying treatment to dependents with sickle cell anaemia, and denying treatment to your partner if you are not formally married.
“Other concerning clauses include a lack of communication about rejected applications, the burden of contributions falling on the unemployed rather than those who need it most, and inadequate transparency around tariffs payable to NHIF,” Amnesty said.
The public had up to May 11 to tender views on the proposed regulations.
Currently, NHIF has about 15 million members, but 8.8 million were unable to make any contributions in the financial year ending 2022.
Only 6.2 million made contributions.
The total membership includes 8.1 million Kenyans registered as informal sector members and were required to pay Sh500 monthly. These will now be required to pay Sh1,000.
NHIF’s financial accounts for the financial year ended June 2022 showed of these 8.1 million jua kali members, only 1.6 million could pay the Sh500.
That year, the fund collected Sh78.84 billion.
According to the International Labour Organisation Strategy Social Health Protection, healthcare costs should not be pushed to the public entirely through taxation.
Globally, governments contribute about 35 per cent to health expenditure through other means but not direct taxes, the ILO says.
The NHIF regulations show the government will pay contributions Sh13,300 a year for Kenyans listed by the state department for social protection as indigent and vulnerable.
Currently, only about one million Kenyans, mostly above 70 years, are listed as indigents.
The higher NHIF contributions are also listed in the Finance Bill 2023 by the Kenya Kwanza regime.
The bill also proposes other tax hikes, including an increase in PAYE from 30 per cent to 35 per cent for employees earning up to Sh500,000.
Workers whose monthly salary is Sh600,000 and above will pay at least Sh5,000 as additional tax.
All unions representing health workers have already rejected the NHIF taxes.
"We cannot subject ourselves to extractive action on workers’ payslips,” said Dr Davji Atellah, secretary general of the Kenya Medical Practitioners Pharmacists and Dentists Union.
"Instead, workers expect a salary increase to deal with the cost of living and inflation."
Atellah said workers cannot bear more deductions.
"Civil servants’ medical allowance was removed from payslip to cover NHIF comprehensive services. And now without a medical allowance or salary increases," he said.