Sen. Pia: 'No one left behind in new PhilHealth Law'

"No one should be left behind."

This is the underlining philosophy of the new PhilHealth Law (Republic Act 10606), says its principal sponsor in the Senate, Sen. Pia Cayetano, Chairman of the Committee on Health and Demography.

"With this new law, we seek to identify and enroll the poorest segments of the population, numbering to about 25 million Filipinos, under the National Health Insurance Program."

"In the past, there was a gap in the law because the poorest of the poor were not covered by PhilHealth unless their local government units or their Congressmen sponsored the payment of their premiums. Only those who could afford to pay the premiums were able to benefit from Philhealth and these would primarily be the formally employed," Cayetano said. "Unfortunately, not all LGUs had the capability to sponsor the PhilHealth enrolment of their poor constituents, while other LGUs do not see this as a priority at all. And so we were left with a situation where the poor were, by-and-large, left out of the national health insurance system when they should be its primary beneficiaries."

"This measure addresses a shortcoming in the implementation of the original PhilHealth law (RA 7875) by ensuring that the poorest of the poor, including the indigents, unemployed, self-employed, and those from the informal sector, would be enrolled in PhilHealth and would actually benefit from its programs and services," she added.

To give effect to the law's provision on mandatory coverage, she said premium contributions for indigent members would be "fully subsidized" by the national government and appropriated in the Department of Health's budget under the annual General Appropriations Act approved by Congress.

Other vulnerable sectors include the lower bracket of the informal economy, such as street hawkers, market and ambulant vendors. Although these low-income groups may not necessarily qualify as poor in the means test of DSWD because of certain factors, their incomes are still not above the poverty line.

"Their membership shall be entirely subsidized by their respective LGUs, or through cost-sharing mechanisms between or among the LGUs, legislative sponsors (senators, congressmen) and other sponsors, including the national government," explained Cayetano.

"The difficult task of identifying and classifying indigent and low-income beneficiaries will be undertaken by the DSWD. But the agency need not start from scratch since it has been implementing the Conditional Cash Transfer (CCT) program for several years already."

Consistent with its principle of universality and compulsory coverage, she said the law mandates LGUs to pay for the premium contributions of all barangay health workers, nutrition scholars, and other barangay workers and volunteers; for employers to shoulder the premium payments of their household workers (also in accordance with the 'Kasambahay Law'); while DSWD will shoulder the contributions of orphans, abandoned minors, out of school youths, street children, and battered women under its care or those of its accredited non-government organizations.

Lastly, members in the formal economy and their employers, as well as government employees and the government agency they work for, shall continue paying the same monthly contributions as provided for by law.

The National Health Insurance Act of 2013 was signed into law by President Benigno S. Aquino III on Wednesday, June 19th. (See .pdf file of the new law on the Official Gazette HERE.)