- The Social Health Insurance Act stipulates that all non-Kenyans who reside in the country shall be eligible for registration as members of the Fund.
- This applies to a non-Kenyan resident ordinarily residing in Kenya for a period exceeding 12 months.
Image: FILE
The Social Health Insurance Act came under serious scrutiny on Wednesday after a Human rights activist took fault with the government over measures introduced by the Act.
Through advocate Harrison Kinyanjui, Enock Aura faulted the government for introducing an Act that seeks to deny Kenyans government services on account of having not been registered under SHIF.
He told Justice Alfred Mabeya, Freda Mugambi and Robert Limo that access to government services will remain inaccessible to unregistered Kenyans by operation of the Social Health Insurance Fund Act, 2023.
"Let's, for instance, say I want to pay my land rates, but because I'm not registered under SHIf, I will not be able to do so. Accessing public services will be impossible. Freedom of movement will be curtailed," said Kinyanjui.
He cited another scenario where there are Kenyans who seek traditional healing.
"We have Kenyans who take traditional medicine...they don't have contact with pathogens found in some foods. That Kenyan has probably never gone to hospital in two decades but now you are telling this person you must register under the new fund!" he posed.
The Social Health Insurance Act stipulates that all non-Kenyans who reside in the country shall be eligible for registration as members of the Fund.
This applies to a non-Kenyan resident ordinarily residing in Kenya for a period exceeding 12 months.
However, a non-Kenyan who intends to enter and remain in the country for less than 12 months shall be required to have travel health insurance coverage.
Kinyanjui argued that the national assembly failed on its mandate as well as the Senate in ensuring that the three acts of parliament were within the framework of the constitution.
He said there was no meaningful public participation and that there was also no publication in the form of Swahili language to inform Kenyans on the three legislations regarding their health.
He took issue with data being collected for purposes of research.
"Lamping all the legislations was a violation of the constitution," he said.
The Social Health Insurance Act, Digital Health Act, Primary Healthcare Act and Facility Improvement Financing Act were assented to by President William Ruto on October 19 last year.
Upon enactment of the said laws, the entire National Health Insurance Fund Act, of 1998, which had been in operation for 25 years was repealed.
The Primary Health Care Act, Section 8 establishes, a primary health workforce including “community health promoters” and “healthcare providers” who are to be assigned to each locality to facilitate access to and ensure the effective delivery of community health services in the community.
However, Aura found fault in questioning whether they had any training or experience on health-related issues before being appointed.
In a swift rejoinder, Senior Counsel Fred Ngatia representing Health CS Susan Nakhumicha said a voluntary medical scheme cannot be sustainable and that is why it has been made mandatory.
"Inability to pay is not an available defence mechanism. Membership is mandatory. For those in the informal sector if they don't have money now, there is Premium financing available," he said.
Ngatia said the concept of mandatory social health insurance for all citizens is rooted in the principles of solidarity.
He said the act has adopted the mandatory health insurance scheme to prevent free-riding, and financial sustainability of the healthcare system, promoting equity and reducing the burden of public finances.
He explained that if the insurance is not mandatory, some people may choose not to participate until they become sick or require medical attention.
This behavior he said can result in adverse selection where only those who are likely to incur high medical costs participate.
"Mandatory health insurance helps prevent such free riding and ensures a more balanced risk pot," he said.
He further explained that with a mandatory health insurance system, the financial burden of healthcare is shared between the government, employers and individuals.
"This can alleviate some of the pressure on public finances, considering that the first of healthcare is distributed across a broader case," he said.
He said it would ensure everyone regardless of their socioeconomic status would have the opportunity to receive medical care when needed.
Further hearing continues on Thursday.