[SIZE=5]What are the major changes being introduced by the proposed NHIF regulations?[/SIZE]
The State wants to drop the old contribution system where salaried workers were contributing between Sh150 and Sh1,700 depending on their monthly pay while those in the formal sector were paying a flat rate of Sh500.
A salaried person will now be required to contribute a standard rate of 2.75 percent of the gross monthly salary towards the NHIF cover. A self-employed person will be expected to make a special contribution of 2.75 percent of the declared or assessed gross monthly income, subject to a minimum of Sh300.
The government is committing to make a Sh13,300 monthly contribution to the NHIF on behalf of people identified as indigent or vulnerable
While the regulations mention “declared or assessed” gross monthly income, it may be difficult for the NHIF to monitor income of the self-employed people and cause them to pay more than the lower limit of Sh300.
For the salaried people earning up to Sh30,000 a month, there is going to be a drop of between three percent and 45 percent in contributions.
However, those earning above Sh30,000 to Sh100,000 will see a rise in contributions by between one percent and 77 percent. Those earning above Sh100,000 will see even steeper deductions.
Salaried workers earning Sh100,000 will start paying Sh2,750, up from the current 1,700, representing a 62 percent rise. Those taking home half a million shillings will see their deductions rise eight times to Sh13,750
[SIZE=5]Is the NHIF going to match the increased contributions with enhanced benefits to the members?[/SIZE]
The draft regulations are not clear on whether the increased contributions will result in enhanced benefits such as more ailments getting insured or reimbursements being increased so that top hospitals that have currently kept off the NHIF can be roped in.
However, there is a reprieve for NHIF members suffering from chronic illnesses such as cancer, cardiovascular diseases, diabetes, respiratory disease and mental health condition.
The proposed regulations provide that members suffering from chronic illnesses will be allowed to access treatment at public hospitals for as long their NHIF contribution is up to date.
This will be of help given that the NHIF currently pays a maximum Sh600,000 for the treatment of cancer in a year.
[SIZE=5]Why does the State want NHIF to have more money?[/SIZE]
The government has been rolling out the universal health coverage (UHC) programme in which it is seeking to provide quality and affordable healthcare for all Kenyans. It has picked NHIF as the primary implementer of UHC.
NHIF is currently grappling with liquidity challenges especially the claims ratio is high and many members are defaulting on premium payments.
The changes are meant to give a lifeline to the NHIF which in the financial year ended June 2022 collected premiums worth Sh78.84 billion against the targeted Sh90.57 billion even as claims shot up.
[SIZE=5]What is the current state of NHIF?[/SIZE]
Data for the financial year ended June 2022 shows that membership grew to 15.4 million in the year ended June 2022 from 13.94 million on continued push for Kenyans to enroll in the scheme.
However, just 1.6 million of the 8.1 million registered informal sector members were making the Sh500 monthly contributions in the year to June 2022. This cost it about Sh39 billion in premiums.
The fund had in a separate disclosure showed total dormant members—from formal and informal sector—hit 8.8 million from 5.03 million the year before, making the insurer miss its Sh90.57 billion targeted premium collections for the review period.
Kenbright Actuarial report on NHIF showed unpaid hospital bills increased from Sh10 billion in December 2021 to Sh15 billion in June last year partly on the cash crunch caused by policy lapses.
I used to support NHIF but that scheme is a scam. I can’t tell you how many deserving fully paid up members get denied authorization for treatment for no reason. Including cancer patients. A patient with histological diagnosis/ confirmation of malignancy na Bado ananyimwa.
You even wonder why they pay in the first place.
This is just a scheme to raise funds for the government. Domestic borrowing shit he was talking about.
If you ask healthcare workers NHIF has been on a trend of declining authorization even when sufficient evidence has been provided. Patients out here are suffering
nhif is shit i tell you. many times nimeenda hosi and i have been forced to dig deep into my pockets for to pay for medicines. kama we si civil servant, keep of nhif completely. hii scheme ya kulipa 500 ni ya upuzi, unaenda hosi unaambiwa iyo ni ya kulipa consultations pekee, lab test na madawa uko pekee yako. the only lab test washawai nilipia ni blood test, urine test, stool test na blood sugar test and those are the normal tests that in medical camps are done for free.