State, counties to give healthcare cover cash to poor

The National Hospital Insurance Fund building in Nairobi. FILE PHOTO | JEFF ANGOTE | NMG

The national and county governments are set to appropriate funds to meet contributions to the new Social Health Insurance Fund (NHIF) on behalf of poor households.

The draft Social Health Insurance Bill 2023 proposes that the State also cover contributions by persons held in lawful custody.

“Contributions under this Act in the case of a household in need of financial assistance as determined by the means testing instrument, (a tool determining whether an individual or household has the ability to pay for their social health insurance premium) shall be paid by the government at a rate apportioned from fund appropriated by Parliament and county assemblies for that purpose,” reads part of the draft bill.

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The government is also tasked with ensuring that premium financing products, which allow persons to meet contributions through staggered payments, will be available and provided to non-salaried persons for the payment of social insurance.

By assuming the contributory role for poor households, the government will be in effect propelling the previously piloted Universal Health Coverage (UHC) programme across all 47 counties.

Under the UHC pilot, which was undertaken in four counties in 2018, the government complemented the scheme that desired to attain ubiquitous access to quality health services for all, by meeting payments to the NHIF for the poor.

Salaried persons shall pay a monthly statutory deduction at the proposed 2.75 percent of gross earnings.

Persons or households whose income is not derived from salaried employment shall make an annual contribution to the fund.

Persons who fail to meet contributions to the fund shall be liable to a penalty equal to 10 percent of the amount due for payment for the period in which it remains unpaid and the total annual contributions.

“The principal object of the Bill is to put in place a legislative framework to regulate the provision of social health insurance, promote the implementation of the Universal Health Coverage and to ensure that all Kenyans have access to affordable and comprehensive quality health services,” reads part of the statement of the objects and reasons of the proposed law.

Read: State eyes NHIF household contribution for wider reach

The Bill is set to mark the winding up of the NHIF and usher in a new regime defined by three separate funds — one for preventive and primary healthcare, another for primary referrals and a third covering treatment of chronic diseases.

A new entity to be known as the Social Health Authority shall manage the three funds and register beneficiaries.

A board led by a non-executive chairperson, including the PSs in charge of Health and Finance, shall manage the authority.

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