It's official, all Kenyans will pay 2.75 pc to new medical scheme

Health CS Susan Nakhumicha. [Boniface Okendo, Standard]

It has now emerged that all Kenyans will pay 2.75 per cent to the social health scheme.

This is according to the new regulations established by Health Cabinet Secretary Susan Nakhumicha and the newly established Social Health Authority (SHA) board.

According to the regulations, employees will pay 2.75 per cent of gross salary to the kitty. Non-salaried Kenyans, on the other hand, will pay 2.75 per cent of their earnings to the medical kitty.

"Every Kenyan will pay 2.75 per cent for medical cover. Those not working will not be exempted as they will have the same percentage deducted from activities that generate their income like farming and businesses," said a senior source at the Ministry of Health.

Under the regulations, there is no maximum capping on the amount to be paid to the kitty, but the least amount is Sh300. The tariff aligns with President Willaim Ruto's pronouncement made early this year.

Structurally, the regulation dictating the minimum contribution to the health cover is embedded under the Social Health Insurance Act, 2023. This is slightly lower than the Sh500 that was being paid to the National Health Insurance Fund (NHIF).

The contribution of the current amount was also agreed on by the NHIF board, which Nakhumicha has criticised saying the contribution was aimed at salaried individuals.

New regulations

A senior source at the Ministry of Health explained to The Standard in confidence that after signing the Universal Health Coverage (UHC) Acts, the CS, in consultation with the SHA board, was to come up with regulations to oversee the implementation of the Social Health Insurance Act, 2023.

"As per the statutory instrument Act, the CS and the board were to decide on the mode of premiums, how it will be done, and what will be included," added the source.

But the source explained that regulations are not in the main law because they "do allow room for changes and review".

The regulations, dubbed the Social Health Insurance (General) Regulations, 2023, have been finalised.

On Monday, the ministry issued a public notice calling for comments and announcing the commencement of the public participation process.

However, as the ministry prepared to start the public participation process, Justice Chacha Mwita granted orders halting the implementation of the Acts.

The Acts include the Primary Healthcare Act, the Social Health Insurance Act and the Emergency, Chronic and Critical Illness Fund.

The case had been filed at the High Court by Joseph Enock Aura on grounds that it was illegal for the government to deny Kenyans services if one was not a member of the medical kitty.

Not publish

The ministry can therefore not publish the regulations until the matter is settled by the court.

The Social Health Insurance Act No. 16 of 2023 was enacted on October 19, 2023.

According to the Act, all Kenyans will pay, and those who defy denied government services.

Public participation was to bring Kenyans across the board to give their opinions on whether they agreed to the amount to be contributed to the kitty.

"In pursuant to Article 10 of the Constitution as read with Section 5 and 6 of the Statutory Instruments Act No. 23 of 2013, the Cabinet Secretary, in consultation with the board of Social Health Authority (SHA), invites interested members of the public stakeholders, and organisations to submit any comments, views or make representations regarding the two (2) draft regulations and the draft Regulatory Impact Statement," reads a section of newspaper advertisement.

According to the advertisement, the Social Health Insurance (General) Regulations object of the regulations are to provide for the implementation of the Primary Healthcare Fund, Social Health Insurance Fund and Emergency.

The public was also to be sensitised on the Social Health Insurance (dispute Tribunal Regulations, 2023).

After public participation, the regulations were to be taken to the National Assembly, being a delegation responsibility, and have the document published in the Kenya Gazette for implementation.

"The court has barred us from implementing the three Acts. Until the matter has been heard, we cannot publish the regulations," said the source.

The regulation will be made available at the Ministry of Health portal. By the time of going to press, the document had not been made available.

Apart from the tariffs which Kenyans will pay to the medical scheme, the regulations also explain the benefits Kenyans will get from SHA.

Before the High Court halted the implementation of the laws, a section of healthcare providers were already meeting in Naivasha for a sensitisation meeting.

However, efforts by The Standard to get a comment from Health CS on the way forward were not successful.

On several occasions, President Ruto has pronounced that changes at NHIF is the road to the attainment of Universal Health Coverage (UHC), which the former regime failed to deliver to Kenyans.

UHC was a big agenda under Jubilee government, that saw the former President officially launch it in Mombasa in 2021.

The programme was launched after successful piloting in Kisumu, Isiolo, Nyeri and Machakos in 2019.

To jump-start UHC, Ruto pushed for the establishment of the Social Health Insurance Act, 2023, which provides for the formation of Social Health Authority (SHA).

According to structures in place, SHA will repeal the current National Health Insurance Fund Act of 1998.

Ruto is expected to officially roll out UHC on January 1, 2024.