Every Kenyan above the age of 18 will now be required to make an annual compulsory contribution of Sh6,000 to the National Hospital Insurance Fund (NHIF) following a bill passed by parliament last week. The recent bill that was passed came as part of the government’s plan to reposition the National Health Insurance Fund (NHIF) into a strategic purchaser and implement a Universal Health Coverage (UHC). It targets more than 16 million adults who have not enrolled for NHIF. Statistics show that about 25.36 million Kenyans are over 18 years of age, NHIF has 8.898 million registered members. All adults will be mandated to pay Sh500 monthly in a redesigned universal health coverage (UHC) scheme for outpatient and inpatient services, including maternity, dialysis, cancer treatment and surgery. The UHC is built on the US’s Obamacare that requires all Americans to buy insurance cover. Kenya has prioritised the attainment of UHC by 2022 hence the reforms in NHIF.
Initially, the formally employed individuals were the only ones mandated to pay for NHIF. Self-employed and unemployed people were to subscribe to NHIF voluntarily. Parents who were members of NHIF were permitted to register their children as beneficiaries until they turn 18. NHIF continued to cover said beneficiaries up to 21 years provided they had no livelihood and were still fully dependent on their contributors. Only the physically or mentally challenged and fully dependent on contributors were ruled out from getting their own cover after 21 years.
The biggest beneficiary of this new shift in policy is NHIF. It is highly likely to be the richest state-backed firm after the passed bill is implemented into law. Employers on the other hand are getting the short end of the stick. They will be compelled to match employees’ monthly contributions to the Fund. Failure to do so in time will be liable to penalties and fines. Private insuring companies will also dance to a similar tune like that of employers. The bill proposed that private insurers incur the first cost for beneficiaries with other health insurance plans.
All these reforms sound solid, but how easy is the implementation process going to be? How will the government enforce mandatory contribution? Contributions from salaried adults will be easy to collect and keep track of, but what about those from the informal sector? Most companies that offer informal employment hardly keep distinct records. The workers are paid either on an hourly, daily or weekly basis. There is need to put in place systems and processes that establish total compliance with this new laws.
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