You will contribute to the social health fund even without a job

Kenyans aged 25 years and above will be required to contribute to the new Social Health Authority (SHA) regardless of employment status.

According to the Ministry of Health, those who are not able to pay will be supported by either their parents or guardians or if not, the government will pay for their cover under indigents.

However, before being clustered under indigents, they will be vetted to determine whether they are legible for government support.

Social Health Authority (SHA) Chairman Dr Timothy Olweny said a person who is 25 years old should not be a dependant.

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“If they cannot pay, someone must pay for them. If for whatever reason they are not able to pay, they will be paid for by a relative or the government,” said Dr Olweny.

According to Social Health Insurance Regulations, 2024, anyone who is above 25 years old should pay to the scheme regardless of their employment status.

“A person who has attained the age of 25 years and has no income of his or her own or is living with the contributor shall be treated as a household separate from the contributor and shall pay Sh300 per month,” reads the regulations.

Health Cabinet Secretary Susan Nakhumicha said 25-year-olds need medical cover to enable them to access quality healthcare.

“Do they get sick, or they do not get sick? Do they apply to get sick, or they do not?, posed the CS.

She added, “When we start asking questions as to why we want them registered and pay for insurance, I think we are forgetting they also get sick.’’

“When I move around the country, the majority of people I see riding boda bodas are in this age group.

“Go to a facility like Moi Teaching and Referral Hospital, there is a whole ward for people who have been involved in boda boda accidents, and it is very expensive to get a knee or hip replacement,” she said.

In the new law, all Kenyans will be expected to pay for the scheme.

Also, in the regulations, a contributor will pay separately for each individual spouse under the Social Health Insurance Fund (SHIF).

Presidential Health advisor, Dr Daniel Mwai, explained that if two people are employed in government and are married, they will both contribute 2.75 per cent to the scheme.

“If I am earning Sh100,000 and my wife Sh100,000 our income is Sh200, 000 and the deduction will be 2.75 per cent,” explained Mwai.

According to the Social Health Insurance Act, 2023, a contributor is expected to pay for each individual spouse, in cases where a contributor has more than one spouse.

The contributor will be expected to provide proof of marriage documents for each individual spouse.

Dr Olweny said the 2.75 per cent SHIF contribution of one’s income will be paid regardless if one is in formal or informal employment.

Payment for those in the informal sector will be done annually.

Olweny said SHA has no schemes, as the National Health Insurance Fund (NHIF), which is set to be shut down.

“NHIF has more than 90 schemes, and the perception is that it is discriminatory,” said Olweny.

Olweny said big earners are contributing a smaller proportion of their earnings to NHIF compared to low-income earners.

He said individuals earning high incomes in the SHA scheme will pay more.

“We realised that we cannot go far with NHIF under Kenya Kwanza Government plans. That is why we took a 360-degree turn, and we introduced reforms,” said Medical Services PS Harry Kimtai

The reforms, he said, established four bills, now laws, to enhance reforms in the health sector.

The laws are Social Health Insurance Act, Public Healthcare Act, Digital Health Act and Finance Insurance Fund Act.