- The Supreme Court determined that SHIF deductions were unlawful, stating that the government was discriminating against individuals employed in the formal sector.
- However, the Ministry of Health claims that there are no "free riders" in its filings with the Court of Appeal.
- The ministry stated that only 13% of the population bore the heavy responsibility of contributions to the new program, and therefore, those who hustled must pay.
Kenya's Ministry of Health has announced that a loan facility will be utilized to enlist Kenyans working in the informal sector to contribute to the Social Health Insurance Fund (SHIF).
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The ministry informed the Court of Appeal that the hustlers can access the necessary funds for their contributions and make interest-bearing repayments afterwards.
In 2023, judges David Manjanja, Christine Meoli, and Lawrence Mugambi of the High Court ruled that the payments were unlawful, citing the government's discriminatory treatment of individuals employed in the formal sector who made mandatory contributions.
The judges stated that the Kenya Kwanza Alliance administration had categorized employed individuals as "low-hanging fruit" for the new health scheme.
The Ministry of Health is emphasizing that there should be no "free riders".
The ministry stated that there are no "free riders" in its proposals. It clarified that the government will cover costs for children and the underprivileged.
The ministry emphasized that individuals operating in the informal sector must either pay for SHIF or opt for a government-issued loan in order to make their contributions.
The High Court recognized the argument made by the appellant that in order to achieve universal membership, some form of enforcement or incentive was required to encourage individuals in the informal sector to join the Social Health Insurance Fund, even if they are not in a life-threatening situation, according to the ministry, as reported by The Standard.
The ministry emphasized that the High Court acknowledged that the National Health Insurance Fund (NHIF), the precursor to SHIF, was unsustainable due to the fact that individuals in the formal sector contributed 83% to NHIF but received only 69% of the benefits, whereas those in the informal sector received 227% more benefits.
It stated that only 13% of the population bore the weight of the contributions to the new system.
The Health CS, Deborah Barasa, highlighted the importance of innovative health financing mechanisms, including SHIF and the Emergency, Chronic, and Critical Illness Fund (ECCIF), to address funding shortfalls and ensure the continuity of healthcare services, according to the ministry.
What was the motivation behind the government's decision to shift from the National Health Insurance Fund (NHIF) to the Social Health Insurance Fund (SHIF)?
The Kenyan government initiated the registration process for SHIF membership in July 2024.
President William Ruto stated that the program will cover all types of diseases, including cancer, blood sugar, and high blood pressure, among others.
He had assured that no Kenyan would have to pay for services once the Universal Health Coverage (UHC) was fully implemented.
He stated that SHIF aims to revolutionize Kenya's healthcare system by ensuring equal and all-encompassing coverage for all citizens, including those previously excluded by NHIF.
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- The government formally launched the new health insurance program in October 2024.
- Kenyans have expressed concerns regarding the relatively low benefits offered under the new scheme.
- The new model deducts 2.75% of the employee's gross salary, with Kenyan employees receiving the same benefits regardless of their individual contributions.