Senators pa*s health insurance bi*l, set stage for major changes

Major changes are expected in the health sectors after Senators passed the Social Health Insurance Bill, 2023, last week, effectively paving the way for the Universal Healthcare Programme.

The Bill is in addition to three others: The Primary Health Care Bill, 2023; the Facilities Improvement Financing Bill; and the Digital Health Bill, 2023; all of which are expected to be assented to this week.

The National Assembly is expected to pass the first and second this week since the Senate already passed them. President Ruto is then expected to assent to all the Bills by Thursday after which he will officially launch the Universal Healthcare Programme during Mashujaa Day celebrations to be held in Kericho this Friday.

The Social Health Insurance Bill, which is now awaiting presidential accent, seeks to provide for the setting up of the Primary Healthcare Fund and the Social Health Authority, the two institutions that will replace the current National Health Insurance Fund (NHIF).

Ironically, a new Chief Executive of NHIF was picked last week and it is not clear how long he will remain in office before the fund is disbanded.

When Senators were discussing the Social Health Insurance Bill, 2023, they said they will now make it possible to set up a fund to cater for emergency, chronic and critical illnesses. It is envisioned that the fund will among other things help patients defray the costs of managing chronic illnesses, a major financial pain point for patients and families who have to pay for health services out of pocket especially if they do not have NHIF or exhaust their allocation.

Quality healthcare

Senate Leader of Majority Aaron Cheruiyot (Kericho), while reading the Bill for the second time, rallied his colleagues to support it, arguing that many families in Kenya spend colossal amounts of money treating their loved ones.

“Over and above the good intentions of this Bill, it is in our best interest as leaders and those that are elite in society, that we make this enabling legislation that provides a national social health insurance that will ensure quality healthcare is affordable to those at the lowest of the pyramid,” he said.

His Nandi counterpart, Samson Cherargei, while supporting the Bill, said it will be one of the enablers of Universal Healthcare. He faulted the current insurance regime, arguing that it only benefits a chosen few.

Insurance coverage in the country has remained largely static at below 20 per cent of the population.

“Every Kenyan born at the commencement of this Bill will have the opportunity to be registered and be part of the medical insurance cover,” Cherargei said on the floor of the Senate.

 “Every farmer is one illness away from poverty. Contribution towards this medical insurance scheme is based on the ability of each and every member.”

It was still not clear by yesterday how much Kenyans will pay to be signed up for the proposed health coverage. A document from the government states that no additional charges, outside NHIF contributions, will be charged.

However, it also warns that late payment will attract a ten per cent interest of the amount due.

Hillary Sigei (Bomet), while also supporting the Bill, said it will support the health of the people, thus increasing the country’s wealth.

“This Bill seeks to improve the management of the healthcare resources of the country. We have had health insurances which are run by the private sector thriving, whereas those run by the Government have had challenges. There is need to make sure that we transform the health sector, in order to make sure that our people are supported by the Government,” he said.

Wajir lawmaker Mohamed Abass said the Social Health Insurance will be an appropriate cover for Kenyans as it seeks to replace NHIF. According to him, most Kenyans cannot afford to pay for insurance premiums offered by private insurance firms, hence the need for the proposed scheme.

One of the provisions in the Bill is that workers employed by NHIF will have to re-apply for their jobs if it is passed into law as widely expected this week.

E-waste materials

However, Nairobi Senator Edwin Sifuna questioned why the drafters of the Bill sought to have NHIF staff re-apply for their jobs in the proposed fund. He argued that the staff should automatically be absorbed.

The First Schedule of the Bill states that the current workers of the National Health Insurance Fund are eligible to apply for the positions to be advertised by the authority and may be considered for appointment where they are suitably qualified.

“There is a depletion of trust in this country. If people were already working for an organisation, they were vetted and are qualified, why would you subject them to a re-application process?” Sifuna asked.

“This is what is causing jitters within NHIF. If these people were competitively recruited, they should automatically be absorbed into the new fund.

“Some of us get very jittery around recruitment in this Government because we have been told of the story of shareholding. Many of us are not shareholders in this Government.”

Besides the Social Health Insurance Bill, the Primary Health Care Bill, 2023 roots for provision of primary health care at community level – with the help of community health workers and the lowest health centres at the grassroots.

Under the Bill, the government seeks to hire 100,000 community health promoters whose roles shall include health education and promotion, disease prevention and control and family health services.

The other proposed law, the Digital Health Bill, 2023 on the other hand, seeks to provide a framework on how Kenyans can benefit from digital health services.

It seeks to develop guidelines for the safe handling and disposal of all health sector related e-waste materials in addition to outlining measures to safeguard the transfer of a client’s medical records to and from facilities outside Kenya

“The Bill seeks to provide for a framework for provision of digital health services; to establish a comprehensive integrated digital health information system, data governance and protection of personal health information, service delivery through digital health interventions, e-waste disposal and health tourism,” it reads in part.