The Ministry of Health has rooted for the new National Health Insurance Fund (Amendment) Bill, 2021 that seeks to compel all adult Kenyans to be NHIF members.
Health PS Susan Mochache said the proposed law will expand the population of Kenyans under universal health coverage and dismissed claims the Bill will wreck the insurance industry.
“The amendments recommend leveraging a complementary model of purchasing health services targeting those with a private health cover,” Mochache said.
The PS spoke when she made a submission to the Senate Health Committee during a virtual public participation forum on Monday.
The Bill, which was passed by the National Assembly a month ago, makes it mandatory for every Kenyan above 18 years to contribute to the fund.
They will pay Sh500 monthly or Sh6,000 annually for outpatient and inpatient services with employers topping for those who pay less than the limit.
The PS said NHIF will continue to pay rebate and capitation amounts contrary to concerns that the Bill will bring down the entire insurance industry.
In July, the Association of Kenya Insurers said the proposed changes in the NHIF act would increase the cost of health care, labour expenses among employers and push medical insurers out of business.
Mochache said when the fund introduced the enhanced benefits in 2015, the institution focused on taking care of the growing needs of its beneficiaries.
However, the PS said it did not define how the benefits were to be utilised.
“The private insurers have since taken advantage of the gap letting NHIF pay for all the newly introduced enhanced packages first,” she said.
Tabling what she termed as statistics for last year, the PS said the private insurance companies collected Sh45 billion in premiums against two million lives.
This, she said, translated to an average of Sh90,000 per family per year collected as premiums.
She said, 98 per cent of the population is left exposed if NHIF does not come in.
“The NHIF, on the other hand, is a family cover where one premium paid will cater for the Principal member, spouse, and children,” the PS said.
Last year, the PS detailed that NHIF which is a national comprehensive collected about Sh60 billion to cover 40.7 per cent of 13.8 million active members at the premium of Sh6,000 per family, translating to an average of Sh1,800 per family per year.
“With this amount, NHIF is fully covering for instance all cases of radiological services, MRI and CT scan countrywide,” she said.
On the concerns raised on the constitution of the board and its autonomy, the PS said the proposal recommends consultation with the Cabinet Secretary from time to time.
“It is, therefore, necessary to promote goodwill and seek support by leaving an opportunity for consultation when it comes to empanelling and contracting such health care providers,” the PS said.
“The system allows the ministry, the regulatory bodies and NHIF to collaborate in carrying out their legal mandates.”
Edited by Kiilu Damaris
