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State set to publish new health insurance charges

A section of Community Health Promoters at the Mama Lucy Kibaki Eye Hospital Annex 2. [Denis Kibuchi, Standard]

Kenyans will know the amount to remit to the newly established Social Health Authority next week. 

The amount shall be fixed by a team of experts that is working on regulations that will oversee the implementation of the scheme. 

 The team was established by Health Cabinet Secretary Susan Nakhumicha last month after President William Ruto signed into law the three Bills that will govern Universal Healthcare Coverage (UHC).

Nakhumicha has already designated the effective date of the Social Health Insurance Act through a gazette notice.

“In exercise of the powers conferred by Section 1 of the Social Health Insurance Act, 2023, the Cabinet Secretary for Health designates the 22nd November 2023, as the date on which the Social Health Insurance Act, 2023, shall come into operation,” reads the notice.

Credible sources confirmed to The Standard that experts, including officials from the ministry, are nearly concluding their work and will table a comprehensive report on Monday next week. 

"The team shall also provide finer details on how the laws shall be implemented," one source divulged. 

President Ruto has also appointed a board to oversee the Social Health Authority.

Ruto appointed Dr Timothy Olweny as the chairperson of SHA.

Olweny, currently the Secretary General of Kenya Association of Private Hospitals was appointed alongside Cotu Secretary General Francis Atwoli, Dr Gichuki Kariuki and Jacinta Mutego, who will serve as members.

The Authority shall oversee the implementation of the Primary Health Fund, Social Health Insurance Fund, and Emergency, Chronic and Critical Illness Fund.

The law provides a framework for improved health outcomes and financial protection in line with the right to health and UHC, which is the Kenya Kwanza administration's key agenda.

Other roles of the law include realigning healthcare systems, processes and programmes for responsiveness, reliability and sustainability of healthcare in Kenya.

 According to structures, National Health Insurance Authority (NHIF), will transition to SHA, in a period of 12 months.

The SHA shall register members to the social fund, manage funds, and receive all contributions and other payments required by the act to be made to the fund.

Under the Act, all Kenyans shall register as members of the Social Health Insurance Fund, expected to fund the UHC programme that will guarantee quality healthcare to all Kenyans. 

Individuals who fail to remit their contributions to SHA shall be denied government services.

“Any person who is registered as a member under the act shall produce proof of compliance with the provisions of this act on registration and contribution as a precondition of dealing with or accessing public services from the national government, county government of a national or county government entities," reads a section of Social Health Insurance Act, 2023. 

However, XN Iraki economist critiqued the move to deny Kenyans services to Kenyans who will not pay the medical cover.

Prof Iraki observed that the provision of quality healthcare services will attract more numbers to enrol on the cover.

"Do we really need to force people to pay for services? Just offer quality services, we see the benefits, we shall come queuing to pay," said Prof Iraki.

"Those who do not pay taxes still use our roads, and get protection from police," he added.

Tariffs to the kitty are however yet to be agreed on.

According to reliable sources at the ministry, the regulation appointed by CS Nakhumicha is deliberating on the amount to be contributed to the insurance kitty.

Earlier this year, President Ruto proposed 2.75 per cent contributions to the scheme, but the amount will be proposed in the regulations.

“Kenyans shall only contribute to Social Health Insurance Fund, after we formulate regulations, at an agreed amount,” said Terry Rotich, a senior ministry official, told The Standard in an earlier interview.

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