By Patricia Mollyne Mataga
The Kenya Kwanza administration is working on replacing the National Health Insurance Fund (NHIF) with the Social Health Insurance Fund (SHIF).
Already, the National Assembly has passed several legislations that will facilitate transitioning from NHIF to SHIF.
Key in a change of the fund is the model of contributions. Currently, the highest-earning Kenyan pays a maximum of Ksh1,700 while the lowest – the unemployed pays Ksh500.
But under the new SHIF, a salaried individual will pay a fixed percentage of 2.75 per cent of his/her gross salary. This means – the higher an individual earns, the more he/she will make contributions to the Insurance Fund.
For example, a Kenyan with a Ksh50,000 gross salary will pay Ksh1,375 from the current rate of Ksh1,200 while those with a payslip that has a gross salary of over Ksh100,000 will pay Ksh2,750 up from Ksh1,700. On the other hand, the lowest amount a Kenyan can pay is Ksh300 every month, down from Ksh500.
Will a Kenyan need to register a fresh to enjoy services under SHIF?
Kenyans who are members of NHIF will be required to register afresh to benefit from the new SHIF.
Currently, NHIF has approximately 14 million registered principal members and about 12.9 dependants, translating to approximately 22.8 million beneficiaries.
“All persons in Kenya shall continue to pay their contributions to the repealed NHIF and receive services under the repealed NHIF and the data of the repealed NHIF shall be retained until all claims have been settled,” said Terry Rotich, the acting corporation secretary at the Social Health Authority (SHA).
Initially, Health Cabinet Secretary Susan Wafula announced that the new scheme would take effect on March 1, 2023.
However, the acting SHA secretary lady clarified that it will start to operationalize on July 1, 2024. Every Kenyan is expected to have registered to be a member of SHIF by June 30th. How the government will determine the amount unemployed Kenyans pay Unlike the current model where an unemployed Kenyan pays Ksh500, under SHIF, every household will be eligible to pay 2.75 per cent of their total income.
The new regulations governing SHIF provide that the household’s income shall be determined by the means-testing instrument.
Benefits of the new SHIF A
A major enhancement of the new insurance scheme is access to treatment for chronic diseases that is limited under NHIF.
CS Wafula was in February quoted saying the new scheme seeks to provide comprehensive health coverage to all Kenyans.
“Under this scheme, vulnerable populations will gain access to a broad spectrum of benefits, including screening, dialysis, kidney transplants, essential medications, and vital medical equipment,” the CS said.
Some of the health experts have also hailed the new scheme as a game changer. National Syndemic Disease Control Council (NSDCC) Chief Executive Officer Dr Ruth Masha argues that the Social Health Insurance Fund represents a transformative initiative aimed at addressing the healthcare needs of the citizens.
“A major ingredient of the Fund is that it comes with huge financial relief to families. Medical expenses exert substantial financial pressure, tipping many families into poverty. President Ruto’s initiative seeks to lessen this by scattering the cost of healthcare across the population,” Masha said.
There have been concerns over the cost of healthcare in the country – with the poor usually forced to seek financial help whenever they require specialized medical care.
Data from the Centers for Disease Control and Prevention indicate that in Kenya, where over 43% of the population lives in poverty, health challenges include high maternal and child mortality and a high burden of infectious diseases such as HIV, tuberculosis, and malaria.
As the government seeks to ensure every Kenyan is registered to SHIF, statistics show health insurance coverage in Kenya has remained below 20% of the population to date.
The majority (88%) of Kenya’s insured population is covered by the NHIF, while the rest are covered by private health insurance.
