NHIF Repeal: Expert Breaks Down Functions Of Ruto's 3 New Funds To Replace National Health Scheme, Their Cost

• President William Ruto's Cabinet approved Bills proposing the repeal of the National Health Insurance Fund (NHIF) to promote Universal Health Coverage (UHC)
• The proposal established three funds, including Primary Health Care Fund, Social Insurance Fund, Emergency, Chronic, and Critical Illness Fund
• Jubilee Insurance Group Chief Executive Officer (CEO) Julius Kipngetich noted the Chronic and Critical Illness Fund will make private health insurance in the country cheaper

Kenyans living with chronic and critical diseases will get medical insurance without subscribing to private insurance.

This is according to a new proposal by the government to repeal the National Health Insurance (NHIF) into Primary Health Care Fund, Social Insurance Fund, Emergency, Chronic, and Critical Illness Fund.

How new NHIF (social protection) fund will work

President William Ruto said the three funds proposed in the new Bills await parliamentary approval and will give Kenyans Universal Health Coverage (UHC), as opposed to the current scheme.

In an exclusive interview with TUKO.co.ke, Jubilee Insurance Group Chief Executive Officer (CEO) Julius Kipngetich explained that the current NHIF approach is a Social Protection Fund.

"...that is what it is known all over the world. Social protection means it takes care of you primarily up to a certain limit. You can buy your NHIF cover under this fund, but there is a limit," said Kipngetich.

Kipngetich noted the monthly premiums for the fund could remain as in the current NHIF scheme, which is KSh 500 per month.

"The fund will be almost shared between the individual and the government because the government cannot afford to pay 100%. You will still pay a basic like KSh 6,000 or KSh 500 monthly. NHIF will still continue as a social protection fund," he explained.

In June 2022, Ruto said employed Kenyans will be required to part with 2.75% of their gross monthly salary, while those earning below KSh 300 contribute KSh 300.

Primary Health Fund

The Bill proposed the establishment of the Primary Health Fund, which is the funding to counties to support district hospitals and dispensaries.

Kipngetich maintained that the fund has been in operation and enables Kenyans to access health from government hospitals for free.

"Through the Primary Health Care Fund, government hospitals are free for... the poor can go to the national hospitals, there is money for that. The county governments will spearhead the fund," he said.

Emergency, Chronic, and Critical Illness Fund.

The government will also establish a fund for chronic illnesses - cancer, high blood pressure, diabetes - to strengthen all referral hospitals like the Kenyatta National Hospital (KNH).

The insurance expert noted that the Emergency, Chronic, and Critical Illness Fund will be fully financed by the state, reducing the burden for many Kenyans who cannot access it through private insurance.

"The other aspect is the chronic illness. Chronic illnesses are very expensive, and private insurers tend to exclude them. The cover will get direct funding from the state ... it is the most significant cover because it has not been there," said the insurance expert.

He added through the new scheme, private insurance will now become cheaper because it will be an add-on to the three covers.

"When these three aspects are taken care of, then private insurance comes on top. You can go as much higher as you want. Insurance premiums will drop because you are not covering chronic, you have social protection, and government hospitals are free."

How new funds will achieve universal health coverage

If passed in parliament, the proposal will play a significant role in implementing UHC in the country.

The CEO said UHC will ensure every Kenyan is covered, spurring growth in private health insurance and improving the country's economy.

"That is how universal health coverage works in countries that have implemented it. When you go to the hospital, you have your government card with the three covers plus additional private insurance. When the two work together, it supports UHC.

It is not a competition with insurance companies, but we complement each other to cover as many people as possible," he said.

Universal Health Coverage (UHC) is among the government's top four agendas, alongside food security, manufacturing, and affordable housing.