‘No SHIF registration, no State services’

Susan Nakhumicha

Health Cabinet Secretary Susan Nakhumicha. She is expected to gazette the regulations to operationalise the Social Health Insurance Act.

Photo credit: File | Nation Media Group

What you need to know:

  • The government is keen to actualise universal health care by having more Kenyans contribute to the new fund.
  • Adult Kenyans, including foreigners living in the country, will be denied access to government services unless they are registered under SHIF.

Adult Kenyans, including foreigners living in the country, who are not members of the Social Health Insurance Fund (SHIF) will be denied access to government services once the Social Health Insurance Act 2023 comes into force.

This is part of the government’s efforts to drive compliance and generate revenue by targeting at least 17 million Kenyans above 18 years who are not members of the National Health Insurance Fund (NHIF), which is set to be replaced by SHIF, to finance universal health coverage (UHC).

Section 26(5) of the SHI Act makes SHIF registration mandator, allowing the national and county governments and their entities to deny services to those who are not members.

“A person who is registerable as a member under this Act shall produce proof of compliance with the provisions of this Act on registration and contribution as a precondition of dealing with or accessing public services from the national government, county government or national or county governments entities,” the law states.

The Act was signed into law on October 19, alongside three other laws. Thee are the Facilities Improvement Financing Act, Primary Health Care Act and Digital Health Act. However, the SHI Act will have to be gazetted by Cabinet Secretary in charge of Health before it is operationalised.

To be a member of SHIF, those in formal employment within the public and private sectors, will be required to part with 2.75 per cent of their salaries in monthly deductions while those in informal employment will be required to contribute Sh500 in monthly instalments.

The law makes it mandatory for non-Kenyans and who are ordinarily resident in Kenya to register with SHIF.”

“A child born after commencement of this Act shall be registered at birth as a member of SHIF,” the Act states adding that registration shall be conducted continuously.

SHIF seeks to ramp up resources to enable the government to roll-out outpatient and inpatient services, maternity, cancer treatment, surgery and dialysis, among others, under UHC.

NHIF data indicates that at least 26 million Kenyans are above 18 years yet the public health insurer has registered slightly above nine million members.

To ensure that the mandatory registration succeeds, one will be required to have an SHIF card before applying for Personal Identification Numbers and other government services.

This means that transfer and licensing of motor vehicles, registration of companies and business names, registration of land titles, approval of development plans among other government services that require PIN, will need proof of SHIF registration.

However, the specific government services to be denied to non-SHIF members will be defined in the regulations to be developed and gazetted by the Health CS.

The last time NHIF reviewed its rates was in 2015. Currently, those in formal employment contribute between Sh1,400 to Sh1,700 monthly depending on their salaries, with the employer matching the same. Self-employed Kenyans or those in informal employment remit a voluntary monthly contribution of Sh500.

Members are required to pay on or before the ninth of the following month to avoid a penalty of 10 per cent.

The 2019 census report showed that Kenya’s working population of between 20 to 64 years is 27.2 million. Of this, only 923,552 are voluntary contributors.