NHIF CEO Announces Changes to Expect in Mandatory Ksh500 Premiums

  • A hand holding a National Hospital Insurance Fund card
    A hand holding a National Hospital Insurance Fund card.
  • The National Hospital Insurance Fund (NHIF) Chief Executive Peter Kamunyo has revealed new changes Kenyans can expect from the mandatory Ksh500 premiums for all households proposed by the institution.

    While participating in a question and answer organised by Nation, Kamunyo noted that Health CS Mutahi Kagwe had created a taskforce to help the fund strategise.

    Part of the resolutions from the taskforce include the introduction of a biometric and electronic claims system and with more services expected to be added under the cover.

    He was responding to a question regarding the services that would be offered under the mandatory premium service despite the organisation being accused of embezzlement in the past.

    National Hospital Insurance Fund CEO Peter Kamunyo Gathege attends a past meeting.
    National Hospital Insurance Fund CEO Peter Kamunyo Gathege attends a past meeting.
    Daily Nation

    "The Cabinet Secretary of Health appointed a Health Financing Reforms Experts Panel to help transform and reposition NHIF as a strategic purchaser of healthcare services

    "The implementation of the reforms is at an advanced stage: the amendment of the NHIF Act is currently in Parliament , the restructuring of our human resource is well underway and the introduction of biometric registration and electronic claims management system is also ongoing," stated Kamunyo.

    "The boost in contribution where members will be expected to pay Ksh500 per month will enable NHIF to broaden the spectrum of service offered," he added.

    While responding to the proposed bill requiring the premium to be mandatory for every household, Kamunyo noted that it is aimed at increasing NHIF's financing pool.

    He noted that out of the 10.4 million Kenyans registered on the platform, only 5 million are active contributors and most of them are either formally salaried hence a requirement or are suffering from chronic illnesses.

    The CEO added that some individuals in the informal sector only contribute when they need the service and stop soon after.

    "Currently, NHIF has a membership of 10.4 million registered members from both the employed and voluntary contributors. Out of the 10.4 million, active members are only about five million. This is attributed to the fact that most members of the informal sector only pay when they have a healthcare need.

    "Those who consistently contribute are mostly those with chronic illnesses or requiring major treatment. Those proposed amendments suggest ways to secure the sustainability of the institution through member retention and revenue flow, including mandatory contribution," he continued.

    In the proposed bill, NHIF increased fines against individual contributors and health facilities by up to 20 times.

    Through the National Hospital Insurance Fund (NHIF) Amendment Bill, 2021, the institution proposed that individuals who obtain benefits through false claims be subjected to a fine of Ksh10 million.

    That is a departure from the current act that provides that the individuals be fined amount not exceeding Ksh 500,000 or imprisonment of 24 months.

    The proposal also increased the imprisonment duration from 24 months to five years.

    National Health and Insurance Fund (NHIF) Offices Building in Nairobi. Monday, November 18, 2019.
    National Health and Insurance Fund (NHIF) Building in Nairobi. Monday, November 18, 2019.
    Simon Kiragu