THE House of Representatives is eyeing a one-year suspension of the monthly premium contributions of the members Philippine Health Insurance Corporation (PhilHealth) if its funds are found to be underutilized.
Speaker Ferdinand Martin Romualdez, in a speech on Wednesday night before the House adjourned session for the Christmas break, said the House will first have to determine if the state insurer can financially handle such a measure, during “a thorough and impartial investigation into how PhilHealth’s funds are being managed.”
“This investigation is not about blame; it is about finding solutions. Our goal is clear: to ensure that every peso in PhilHealth’s coffers works for the benefit of its members – the hardworking Filipino people who contribute month after month,” he said.
The Speaker said if the House determines that existing funds are underutilized or are in excess of what is needed for current operations, the House would recommend a one-year suspension of premium payments for all paying members “as a form of relief to millions of Filipinos already grappling with inflation and rising prices.”
“Why are we doing this? Because the people deserve no less. PhilHealth exists to provide security and comfort in times of medical emergencies. It should not hoard resources at the expense of its members. If we can alleviate the burden of contributions without compromising its sustainability, we will do so,” he said.
Romualdez said the House would also propose to further reduce premium contributions and expand the benefits of members until the vision of zero billing in hospitals is reached.
He vowed to would ensure that PhilHealth will provide expanded healthcare coverage, including additional medical services, hospitalization support and better benefits for those in need.
For workers and employers burdened by rising costs, he said, the House will explore reducing premiums while maintaining PhilHealth’s capacity to deliver its services.
The Speaker said the House “remains vigilant in emphasizing the importance of transparency and accountability of public funds, reaffirming our commitment to safeguarding our most precious resources.”
“This year, we have also exercised our oversight functions with diligence and integrity. Our investigations in aid of legislation have uncovered anomalies, held officials accountable, and pushed for reforms to ensure public funds are spent wisely,” he said.
PhilHealth president Emmanuel Ledesma Jr. earlier said the agency is working for a reduction of members’ premium contribution rates to 3.25 percent from 5 percent while also expanding hospitalization coverage by 50 percent, despite having received no subsidy under the version of the P6.352-trillion proposed national budget for 2025, which was approved by lawmakers in the bicameral level last week.
He made the statement during a briefing with the House Committee on Good Government, where lawmakers called on PhilHealth to better utilize its substantial reserve funds for the benefit of its members.
EXPANDED SERVICES
President Marcos Jr. said PhilHealth services would not be reduced and may even be expanded next year to cover more areas, regardless if government gives it subsidy or not.
The President, in an ambush interview yesterday at an Air Force event, said there would be no reduction in services for senior citizens, the marginalized, the middle class, or any sector.
“So, I would like to just assure everybody, do not worry that the services would be reduced … not even a single centavo single would be removed. Quite the opposite, we would expand that in 2025. More services will be provided by PhilHealth, the payment for insurance claim would even be bigger,” he said in mixed English and Filipino.
MORE BENEFITS
Health Secretary Teodoro Herbosa, chairman of PhilHealth’s Board of Directors, yesterday said the state-run health insurer should be more focused on paying for the medical benefits of its members and not on investment activities.
“PhilHealth needs to pay the health benefits of its members. PhilHealth must not invest government funds in the bank… It must pay its arrears to hospitals and doctors in a timely manner,” he said in a social media post, amid criticisms about PhilHealth covering only a small portion of the medical bills of its members, and delayed reimbursements of hospital and doctor expenses.
Ledesma has said the agency has P281 billion in reserve funds and P150 billion surplus funds, while its investment portfolio is at P489 billion.
PRIMARY MISSION
Herbosa, in a TV interview, said the PhilHealth board has directed the agency’s management to “fix its acts.”
To note, the board is a separate and distinct entity from the agency’s management.
Herbosa said PhilHealth’s primary mission is to shoulder the medical expenses of its members and reimburse the expenses of hospitals and doctors.
“I’m a doctor so I also know that PhilHealth is not paying well, that’s why I want to fix that as well. This is called fiscal discipline,” he said.
“We’re telling the corporation it is supposed to pay for the benefits of its members. Therefore, use the excess money and don’t ask for subsidy,” he added.
Herbosa said the PhilHealth board also wants to improve the healthcare coverage of all members.
“We want the benefits to go higher. Because the middle class and working class are complaining. The poor are getting all the benefits, while the middle class are not. They are actually right,” he said.
“PhilHealth should be able to cover 50 to 70 percent of the hospitalization cost. That’s going to make you want to pay the 5 percent of your salary because you know you’ll be protected,” he added. – With Gerard Naval and Jocelyn Montemayor
