D-Day for Uhuru Kenyatta’s universal healthcare Bill

President Uhuru Kenyatta’s state-backed universal healthcare vision risks being derailed by a standoff in Parliament over the National Hospital Insurance Fund (amendment) Bill he has urged MPs to urgently enact.

Senators have rejected some provisions of the Bill passed by their counterparts in the National Assembly, including mandatory registration of those aged above 18 years and punitive sanctions for fraudsters looting the state medical scheme.

While President Kenyatta is racing against time to provide Kenyans with affordable healthcare, one of his Big Four Agenda before he leaves office in August, the decision by the Senate might delay one of his legacy goals.

While the National Assembly passed the Bill that makes it mandatory for every Kenyan above 18 years to be enrolled in the NHIF, the Senate has dropped the mandatory membership requirement.

Fraudsters

The Senate also reduced the fine and jail term for fraudsters impersonating NHIF enrolled members from Sh1 million passed by the National Assembly, to Sh100,000. It has also reduced the jail term for a person impersonating NHIF members from the two years passed by the National Assembly to six months.

“Clause 35 of the Bill be amended by deleting the words ‘one million shillings or to imprisonment to a term not exceeding 24 months and substituting thereof the words ‘one hundred thousand shillings or to a term not exceeding six months,” the Senate says in the amendments of the Bill.

Members of the National Assembly, while increasing the fine from the current Sh500,000 to Sh1 million, argued that it is meant to curb the rising cases of fraud being presented to NHIF by hospitals.

The fraud usually involves forgery of documents, particularly MRI and CT scans. This has been rampant due to lack of biometrics to identify members and their dependants.

In May, NHIF flagged claims forwarded by a hospital in Nairobi involving a woman who tried using her daughters’ card claiming services worth Sh1.2 million, highlighting the gravity of fraud on the state medical insurer.

Senators also exempted employers from mandatory topping up of contributions for their employees whose pay is less than Sh500.

"An employer other than the national government or county governments or their entities liable to pay a matching contribution under section 15 may be exempted from paying such matching contribution,” reads the amendment done by the Senate.

Employers had petitioned Parliament to reject the proposal in the Bill compelling them to match their workers’ NHIF contributions, saying it will be an added burden as they struggle to recover from the economic falling-out of the coronavirus pandemic.

Penalties

Further, senators have also amended the provision exempting national and county governments from penalties for failed or delayed disbursements to NHIF.

The National Assembly said counties will be penalised for late remittance of the contributions if they have received money from the Treasury but have failed to remit to NHIF.

However, senators dropped the amendments saying it is unfair and prejudicial against employers.

The differences between the two houses on the amendments is likely to play out today when the National Assembly is set to have a special sitting to consider the Bill based on changes made by the Senate.

The Bill was passed by the National Assembly in September and sent to the Senate for concurrence.

The Bill must get approval from both houses, meaning that both senators and members of the National Assembly must agree on its contents before it is presented to President Kenyatta for assent.

Should the National Assembly reject the Senate amendments, it will result in a deadlock that will be referred to a mediation committee consisting of members from both houses that will try to come up with an agreeable version.

During the National Prayer day in May this year, President Kenyatta urged MPs to pass the Bill to allow Kenyans access to quality and affordable healthcare.

Today, the National Assembly will consider the amendments passed by the Senate. Should members of the National Assembly reject the changes done by Senators, the Bill will be referred to mediation.

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