Expand enrolment on NHIF to plug funds gap


Doctors perform a pacemaker placement surgery at a medical camp in Nairobi. FILE PHOTO | NMG

The National Hospital Insurance Fund (NHIF) is in dire need of sustainable funding to enable it pay the rising patient claims.

The relatively affordable package offered by the NHIF also represents the country’s best hope of achieving universal health coverage (UHC).

To its credit, the public health insurer has in recent years made reasonable effort to raise funds, including introducing the flat rate of Sh1,700 for formal sector workers earning over Sh100,000 monthly.

But it has also demonstrated a lack of imagination in basing its premiums too heavily on income levels and placing the burden of contributing to the social health insurance scheme on people in formal employment.

The NHIF has recently had to withdraw regulations requiring workers earning more than Sh100,000 monthly to pay 1.7 percent of their gross salary to the fund following a parliamentary petition by the Kenya Healthcare Federation (KHF).

KHF, a private sector lobby group, was most probably concerned about the commercial interests of its members.

But were the regulations to be enforced, they would have significantly added to the burden on the very small group of informal workers that is already overtaxed and weighed down by Kenya’s high dependency ratio.

Many jobs would also have been put in jeopardy, with employers protesting the rules requiring them to match workers’ contribution and warning of layoffs to offset wage bill increases.

The mounting grievances should challenge the NHIF to explore other options for fundraising, including expanding enrolment.