February 2021 Business daily; Each household will soon make a compulsory Sh500 contribution to the National Hospital Insurance Fund (NHIF) as the State lines up a health cover for all Kenyans.
Treasury Cabinet Secretary Ukur Yatani said each household would part with Sh6,000 annually to be enrolled in a universal health coverage (UHC) scheme for outpatient and inpatient services, including maternity, dialysis, cancer treatment and surgery.
“Government focus is on the establishment of a mandatory UHC scheme to be managed by NHIF and regulated by the Ministry of Health and act as the national scheme for all persons resident in Kenya, notwithstanding one’s social status,” he said in a Budget Policy Statement for the fiscal year 2012/2022.
The planned mandatory NHIF membership for all Kenyans will be an upgrade of the current scheme where only workers in the formal sector are compelled to join.
“Focus is also on provision of health insurance cover to initially one million households who are vulnerable and unable to meet even that low-cost premium. The identification of these one million households by the Ministry of Health, Ministry of Labour and Social Protection, and the counties across the entire country has already begun,” Mr Yatani said.
The State has offered to sponsor one million poor households at the onset of the UHC scheme, which is modelled on the US’s Obamacare that requires all Americans to buy insurance cover.
The Treasury secretary said the plans to roll out the State-backed health insurance were at an advanced stage, with the collection of the beneficiaries’ data already underway.
The Health ministry said a proposed law on the management of the UHC scheme would be tabled in Parliament soon.
“Let the Bill go to Parliament, it will have the details,” Health Cabinet Secretary Mutahi Kagwe told the Business Daily when reached for comment on how the UHC would be run.
The nearly similar universal health cover in the US known as Obamacare is anchored on the Affordable Care Act (ACA) requires everyone to have a health cover and imposes a tax penalty on those who fail to purchase a health insurance plan.
It, however, offers subsidies to those who cannot afford a plan on their own through tax credits and paying insurance companies to keep their deductibles low.
Due to low insurance penetration, a quarter of all Kenyans’ healthcare bills are paid out of pocket, according to the World Bank.
This leaves many families vulnerable and reliant on debt and donations or disposal of assets such as livestock.
Kenya has prioritised the attainment of UHC by 2022 by expanding the NHIF after years of false starts.
When former President Mwai Kibaki took office, the Health ministry introduced a minimal user fee for primary healthcare facilities. The National Social Health Insurance Fund Bill introduced in 2004 proposed that the State pays Sh11 billion to the NHIF annually to meet the insurance costs for the poor.
Mr Kibaki, however, rejected the Bill citing the implications of the huge cost on the economy.
After years of lobbying the NHIF raised workers’ contributions from Sh320 to a graduated scale of between Sh500 and Sh1,700 per month based on each worker’s monthly pay, introducing outpatient cover for contributors and enhanced benefits for specialised treatment such as cancer and kidney dialysis.
President Uhuru Kenyatta is making another attempt to give all Kenyans health cover by 2022 after rolling out a pilot in four counties — Machakos, Nyeri, Isiolo and Kisumu.
The efforts to expand the national insurer’s mandate has often met resistance from the private sector players, who want to maintain status quo fearing loss of revenue.
The State-backed NHIF is the biggest health insurer in the country with a coverage of 15.8 per cent, which is equivalent to over 80 per cent of the total population with any form of health insurance in Kenya.
NHIF membership had grown from 4.4 million in 2013 to 8.4 million in 2019, according to the latest Economic Survey, which is 70 pe cent of the 12.1 million households.
The fund’s receipts grew by 22 percent to Sh58.1 billion in 2018/19 while payouts increased by 36.8 percent to Sh53.4 billion, underlining the high cost of providing the cover.