The state is attempting to remove representatives of doctors, churches, and teachers from the National Hospital Insurance Fund (NHIF) board. This could start a fresh conflict with the workers and employers.
The NHIF Act review via a government-backed Bill could lead to the removal of three directors that represent teachers unions, the Kenya Medical Association (KMA), and faith-based organizations.
According to the bill, the Attorney-General will join the board of the NHIF, giving the government a huge say in the cash-rich fund that collects over Sh. 58 billion from workers every year.
Employers and unions feel that the union belongs to workers who are responsible for funding its operations and not the government. They argue that the position enables them to have the right to influence the strategic direction of the fund via seats on the board.
“I am aware of the proposed changes but the rationale has not been explained. Having the Attorney-General as part of the board is anomalous, he is already an adviser to the government and so he should be removed from the board so as to continue playing the advisory role,” Jacqueline Mugo, the FKE executive director told Business Daily.
The FKE feels that the government, even though it is the single-largest employer, is mainly on the board as a trustee.
FKE normally represents the employers who remit over half of the NHIF contributions.
The Kenya National Union of Teachers and COTU handle the interests of the workers.
In three years, this is the second time that the government has tried to remove NHIF directors gotten from the teachers’ union, faith-based organizations as well as the doctors association.
A similar push of removing representatives via a review of the NHIF Act did not go through in 2018.
At the end of June, the NHIF board had 8.466 million members with 4.299 million from the formal sector while 4.167 million are from the informal sector.
The Review of the NHIF board comes as the State is considering what to do with the universal health coverage (UHC) scheme for outpatient and inpatient services, including maternity, cancer, dialysis, surgery, and treatment.
Every household will need to make a compulsory monthly contribution of Sh. 500 or Sh. 6000 every year to the NHIF as they seek to offer health cover for all Kenyans.
The Planned Mandatory NHIF membership will be an upgrade on the ongoing scheme where only workers who are in the formal sector have to join.
The state is offering to sponsor one million poor households at the beginning of the UHC scheme. The UHC is modeled on the United States’ Obamacare that requires all Americans to buy an insurance cover.
According to the World Bank, because of the low penetration of insurance, one-quarter of all healthcare bills of Kenyans are paid from their pockets.
This means many families are vulnerable and reliant on debt and donations from other disposals of assets like livestock.
Attainment of the UHC is expected to be by 2022. This will expand NHIF after many years of false starts.