Having all adults on NHIF major step to healthier Kenya


The National Hospital Insurance Fund (NHIF) in this picture taken on Tuesday, October 26, 2021. PHOTO | DENNIS ONSONGO | NMG

The National Health Insurance Fund (NHIF) Amendment Bill 2021 passed by the National Assembly recently is a timely intervention. The Bill provides the necessary legal framework for the attainment of Universal Health Coverage (UHC) in the country.

The National Assembly passed the Bill without changes to the amendments made by the Senate earlier. I commend the two houses of Parliament for putting the health of Kenyans first.

In my view, accelerating the attainment of UHC is one of the best gifts the legislators could have given their electorate coming at a time when the world is battling Covid-19.

The NHIF Amendment Bill is a win for all. Those who were previously not covered by the Fund will now be covered, healthcare providers will now find it easier to realise their markups and NHIF will be able to offer an expanded package.

The bill makes it mandatory for all Kenyans aged above 18 to have NHIF membership. Currently, many people working in the informal sector have not enrolled into the programme due to its voluntary nature.

NHIF currently covers over 31 million Kenyans. However, the number of people actively contributing stands low at about 40 percent of the registered members.

With more contributors, it will now be easier for NHIF to create a sufficient financial base to provide health cover to all Kenyans. The higher the number of members, the less a benefit package will cost due to economies of scale.

Universal health coverage will make fundraisers to cater for hospital bills a thing of the past. At the moment, it is common to see even Kenyans deemed to be well-off organising a fundraiser whenever a family member falls sick.

Better still, the amended law prevents NHIF from withdrawing the benefits of a person undergoing treatment for a chronic illness, a welcome move considering the increasing number of Kenyans suffering non-communicable diseases in the recent past.

Under the amended law, the NHIF board will carry out a review of applicable tariffs payable out of the fund to contracted healthcare providers every two years.

This will enable the health insurer to periodically increase its funding pool to match the rise in treatment costs. NHIF last reviewed its rates in 2015.

Additionally, the biennial review will enable the Fund to seal loopholes that some dishonest health service providers have been using to enrich themselves at the expense of Kenyans.

While it is important to punish and deter fraudsters, it is equally important not to be seen as being too punitive as this reduces the willingness of the public to report fraudulent activities.

Hence, the decision by Senate to reduce the penalty for insurance fraud from Sh1 million to Sh100,000 or a six-month jail term will encourage more Kenyans to report on fraudsters.

The amended law has something for employers too. It exempts employers from paying a matching contribution for their employees if the employer has procured a private health insurance cover. Overall, NHIF will become more sustainable, and more Kenyans will benefit.