No services without NHIF registration

Thursday, January 20th, 2022 07:23 | By
Health Cabinet Secretary Mutahi Kagwe addresses the press at Afya House in Nairobi. Photo/PD/ALEX MBURU

Kenyans aged 18 years and above will not access government services if they are not registered with the National Health Insurance Fund (NHIF), it has emerged.

This will affect even mama mbogas, shoe shiners, boda boda operators among other smallest scale entrepreneurs, and even merchants who want to do business with the government.

This is according to new regulations being developed by the NHIF to operationalise the new NHIF Amendment Act 2021 which came into force this week.

The NSSF’s board chair Lewis Nguyai said the new law President Uhauru Kenyatta assented to early in the week is expected to be gazetted tomorrow.

“You may not be able to renew your business operating licenses if you are not an NHIF card holder,” he said at Jumuia Hospital in Huruma yesterday where Health Cabinet Secretary. Mutahi Kagwe launched the Afia Njema Programme, a product of the National Council of Churches of Kenya (NCCK).

“If you are a mama mboga and you are known that you provide certain services, it will be important for you - before you are given that county government piece of paper - that you show that you are an NHIF fully paid member,´ he added.

This practically means that by May this year, critical services offered by the government may be unavailable to adult Kenyans without NHIF identification.

Currently, a task force working on NHIF reforms and the Fund’s Board are meeting in Naivasha to fine tune the regulations. However, the same will be subjected to public participation until April 20 this year, as the government looks to start implementing the new law. Nguyai said once a Kenyan attains the age of 18, they will be obligated to contribute to the NHIF, as defined by the proposed regulations.

“Because we have very many Kenyans who are not earning an income, of whom we will make a definition for. But it will be mandatory for those who call themselves unemployed to have an NHIF card,” he said.

“At present and for the next two years the NHIF contributions will remain the same. The act now provides powers for the board to determine the extent of contribution but it can only be done and reviewed every two years,” Nguyai said.

Principal members
Currently, the cover is Sh500 per family which caters for a principal member, their spouse and their children who are under 18 years.

“Once you surpass 18 you become an adult and now it is becoming mandatory for you to contribute and we are in the regulations to determine who is mandatory for because we have very many Kenyans who are not earning an income so those who are not earning an income we will make a definition,” he noted.

The new law will see all adults compelled to pay Sh500 monthly or Sh6,000 annually in a remodelled Universal Health Coverage (UHC) scheme for outpatient and inpatient services, including maternity, dialysis, cancer treatment and surgery.

Kagwe called on county governments to work with the National Government Administration Officers (NGAO) and faith based organisations such as churches to help identify vulnerable Kenyans who should be helped to pay for their premiums.

“These clergy know their flock, they know who is very poor and they know who can afford it because sometimes when you ask for these lists you have to remove 200,000 people because you have identified them as people who are able,” Kagwe said.

“They are going to be called healthcare providers as they are going to be known under the new contracts. It will involve people who provide healthcare services; or both public and private health facilities, pharmacies or people who use technologies such as telemedicine,” he added.

Nguyai argued that the card is more beneficial to Kenyans especially from poor set-ups who cannot afford healthcare services in high end health facilities. He said a principal contributor can pay for about five people using the mandatory Sh500, but if one of them is diagnosed with a cancerous condition, there is a Sh600, 000 benefit to it. 

“So I would like to urge people, instead of seeing it as a mandatory undertaking, to see it as a form of incentive for them to look at the benefits from the payment they are making,” he added even as legal experts cautioned about pushing Kenyans to take the cover as it may be encroaching into their right of choice.

However, Lawyer Morara Omoke argued health insurance is generally good for Kenyans, if the government makes it work for them as an ordinary medical cover.

“You can look at the whole programme from two sides; the positive side, which outweighs the negative side, if the system is supported by the government to work for people sufficiently. We can also look at it from the negative perspective, if Kenyans are forced to take it if they don’t consider it beneficial,” he said.

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