Coming soon? Compulsory NHIF contributions

Employed Kenyans to support the unemployed to access health services. [Elvis Ogina, Standard]

It will be mandatory for all Kenyans to contribute to the public health insurance scheme, according to a new law.

The mandatory payment is to finance the Universal Health Coverage (UHC) and make it sustainable for all Kenyans to access quality healthcare.

President Uhuru Kenyatta plans to roll out UHC tomorrow. Its financier will be the National Health Insurance Fund (NHIF) under the newly signed NHIF Amendment Bill 2022. UHC was one of Uhuru’s Big Four agenda, aimed at guaranteeing quality, affordable healthcare.

Health CS Mutahi Kagwe reaffirmed that “the government will not impoverish Kenyans when they are sick by putting them through another disadvantage of financial stress.”   

One beneficiary during the pilot programme of UHC was 80-year-old Samuel Mutembei. His wife’s hypertension is being managed through the scheme. “My wife requires about Sh9,000 every month to manage her sugars, money that I cannot raise. I am thankful because the bill is catered for by NHIF,” said Mr Mutembei.

According to Kenya Health Financing Strategy (KHFS) 2020-2030, Kenya intends to attain UHC and its sustainability predominantly through domestic financing, with the primary sources being tax funding and health insurance contributions.

Health CAS Mercy Mwangangi said under the model, Kenyans who are employed will support the unemployed to access health services without much strain.

“All Kenyans must be in one basket so that the young Kenyan is paying for the old Kenyan, the rich Kenyan is paying for the poor Kenyan, the Kenyan who is not sick is paying for the sick Kenyan,” said Dr Mwangangi.

With adoption of the ‘pool resource’ model, at least 4.9 million poor households will access quality health-care across the country - household, according to the Kenya National Bureau of Statistics.

The government will spend Sh30 billion, enrolling the poor to NHIF super-cover at Sh6,000 per household with about 1.4 million households covered in Phase One under the current financial year. Subsequently, the future governments will be expected and mandated by law to roll into the scheme the 5 million households.

The government has also identified and registered one million needy people countrywide to benefit from the scheme and “community leaders at county level are being used to identify needy households, who will be verified,” said Dr Mwangangi. To avoid defaulting, for example by self-employed boda boda operators, the government will use associations to ensure they remit their pay, while cooperatives will be used to capture pay for farmers, said Dr Mwangangi.

The total gross premiums for health insurance industry in Kenya is Sh54 billion, of which, Sh28.5 billion is paid to NHIF and the balance to private insurance. Currently, the amount of money allocated for mandatory insurance scheme is minimal, relative to overall health expenditure.

The number of people who have subscribed to NHIF has increased from 4 million in 2014 to over 13.9 million principal members and “the response of Kenyans joining NHIF scheme has been great,” said NHIF CEO, Dr Peter Kamunyo.

NHIF report of the Association of Kenya insurers shows that there were 17 private insurance companies offering health insurance products with NHIF controlling 88.4 per cent and the others sharing out 11.6 per cent as per Kenya National Health Accounts for 2015 and 2016.