NHIF should scrap reactivation fee


The National Health Insurance Fund building in Nairobi in this photo taken on February 9, 2022. PHOTO | JEFF ANGOTE | NMG

What you need to know:

One of the biggest challenges the government will be facing is the provision of universal healthcare.

This is after the latest National Health Insurance Fund (NHIF) data for this financial year showed that dormant members have hit 8.8 million from 5.03 million the year before.

This rise is equivalent to 43 percent of NHIF members translating into the agency missing the Sh90.57 billion target on premiums.

Consequentially, this means the defaulters will be relying on out-of-pocket medical expenses.

The state of a country’s healthcare financing is analysed by the percentage of the population that pays healthcare bills out of pocket; the more citizens do this the more broken the healthcare financing of a country.

It is the business of the government to ensure its population spends as low as possible on healthcare while maintaining a sufficient supply of services.

In developed countries, healthcare financing is one of the most substantial policy issues, with the government making baseline coverage available to all.

In the US, “Medicare for All” is one of the most debated and contentious policies in the last decade.

In Kenya, the NHIF membership stands at 15.4 million but only 6.7 million are active, meaning more than half of the members have to foot their own bill.

This drop in active contributors is linked to the tough economic times.

So, how can this be resolved?

This is a tough call for the government because if the economic recovery is delayed it means more people are condemned to out-of-pocket spending on healthcare, therefore their financial status is deteriorating.

At the same time, the government is financially constrained to intervene and provide free access to healthcare to millions of Kenyans who have no health cover.

So, a prolonged economic recovery means more Kenyans are vulnerable to health scares.

What NHIF should highly consider is their policy on re-admission because when registered members default on the monthly premiums, they are usually locked out of using their insurance covers and must pay a 50 percent penalty on the minimum Sh500 premium.

And to be re-admitted, condemned members require defaulters to pay Sh1,500 to reactivate their membership and wait for three months before becoming eligible.

They also have to settle their arrears first before they can be eligible for the cover.

This re-admission policy makes it expensive for condemned members to return to public health cover which should not be the case.

As the government is planning to roll out its Universal Health Coverage, it should give due consideration to this re-admission policy.

It’s time to consider scrapping the Sh1,500 reactivation fee because it’s an unnecessary barrier to the cover.

PAYE Tax Calculator

Note: The results are not exact but very close to the actual.