Premium payment break for poor PhilHealth members pushed
MARIKINA 2nd District Rep. Stella Quimbo filed a proposed House resolution urging PhilHealth to suspend premium contributions for minimum wage earners, whether employed or self-employed.
Quimbo sought the suspension pending review of the expansion of PhilHealth member benefits.
“The unspent premium of PhilHealth can very well cover the premium contributions of minimum wage earners for at least a year since in 2022 their premium contribution only amounted to P19.6 billion,” she said.
The proposed resolution, filed on Monday, February 19, stated that PhilHealth’s reserve fund “is expected to have grown by 68 percent” to P463.7 billion by the end of 2023 from P275.8 billion in 2022.
“The 2022 unspent appropriations for premium subsidies amounting to P24 billion can be utilized to subsidize the employee share in premium contributions of minimum wage earners and the premium contributions of self-employed individuals earning minimum wage in 2024,” it said.
“Suspending the employee share in PhilHealth premium contributions of minimum wage earners will result in an average monthly wage increase of approximately P400 in the NCR (National Capital Region) or Metro Manila for non-agricultural workers.”
The suspension being sought shall not exceed one year.
“This temporary suspension is not just about providing short-term economic relief but also about initiating a comprehensive review of PhilHealth’s benefits and contribution structure. The goal is to expand health benefits for all members and potentially reform the contribution structure, or even to possibly eliminate premiums for minimum wage earners and self-employed individuals earning the equivalent of minimum wages,” Quimbo said.
Congress in 2022 appropriated P80 billion as subsidy for the premiums of indigent families, senior citizens and persons with disabilities.
However, “benefit claims for this sector were only P56 billion, resulting in a net flow of P24 billion.”
“The aim of the review is to have benefit packages that are designed to prevent illnesses and to provide more support when hospitalized. In the long run, it is cheaper to prevent than to cure,” Quimbo said.
Moreover, she said that when PhilHealth gives enough support, Filipinos will no longer wait until their illness worsens before they see a doctor.
“In the end, we can have a more rational spending on health care. This will boil down to a more rational amount of PhilHealth contributions by our workers, as well as annual appropriations from Congress,” Quimbo said.
On Feb. 13, 2024, Speaker Ferdinand Martin Romualdez ordered the House Committee on Health to review PhilHealth’s charter to expand patients’ benefits.
PhilHealth President and Chief Executive Officer Emmanuel Ledesma Jr. said that increasing the benefit packages is the agency’s prime mandate.
“We have to increase the benefit packages, make things easier for the people. The less out-of-pocket [expenses], the better for the country and the better for the health system of the country,” said Ledesma.
He said that recently, PhilHealth’s benefit panel approved the enhancement of the Z Benefit for breast cancer.
The coverage for high-risk pneumonia was increased to P90,100 from P32,000 while the Z Benefits package for colon and rectal cancers was enhanced, “allowing patients with metachronous colorectal tumors to re-avail the package for colon and rectal cancer.”
He also said that the package rate for select orthopedic implants was increased.