SHIF: Race against time to craft rules for new health cover

susan nakhumicha, health cs

Health Cabinet Secretary Susan Nakhumicha. 

Photo credit: File | Nation Media Group

What you need to know:

  • The Court of Appeal lifted a ban on the implementation of the law.
  • The regulations do not necessarily require the approval of Parliament before they become operational.

The Ministry of Health is working round the clock to have regulations that will enable implementation of the Social Health Insurance (SHI) Act 2023 in place this week.

Sources have indicated that the goal is to have deductions effected starting this month.

The publication of regulations by Health Cabinet Secretary Susan Nakhumicha is the only hurdle that stands in the way of President William Ruto’s desire to realise Universal Health Coverage (UHC) for all in the country.

This follows an order by the Court of Appeal on Friday last week, lifting the ban on the implementation of the law, which effectively delayed the publication of the Social Health Insurance (General) Regulations, 2023.

The regulations seen by the Nation, seek to enhance contributions to the Social Health Insurance Fund (SHIF) by making salaried employees contribute 2.75 percent of their basic monthly pay as it sets Sh300 per month as the mandatory minimum contributions from unsalaried people.

CS Nakhumicha yesterday said that the fund, anchored in the country’s health finance mechanism, will “equitably protect people against financial and health burdens through a monthly premium.”

“SHIF remains one of the mechanisms for achieving UHC which aims to advance quality and affordable healthcare to all Kenyans regardless of their financial abilities across all levels of government hospital,” said CS Nakhumicha.

The regulations do not necessarily require the approval of Parliament before they become operational, at least according to the Statutory Instruments Act.

The law provides that only regulations with the force of taxation require the positive approval of Parliament before they come into force.

Nonetheless, the same law states that any government agency with the power to generate regulations must present them to Parliament and if they are annulled, they cannot be implemented.

To be published by the CS, the regulations must have been approved by the Social Health Authority Board and subjected to public participation.

The SHI Act was enacted last year and on November 22, 2023 CS Nakhumicha gazetted it, effectively operationalising a regime that seeks to replace the National Health Insurance Fund (NHIF) before it was injuncted by a court order.

The act establishes the Social Health Authority (SHA), to be headed by a Director-General and overseen by a board headed by a non-executive chairman.

Other than SHIF, the Act also establishes two other funds- the Primary Health Care Fund (PHCF) and the Emergency, Chronic and Critical Illness Fund (ECCIF) and provides how health service will be provided by the three funds.

Initially, the government had hoped to have the regulations in place by December 31, 2023 to pave the way for the enhanced deductions and mandatory contributions from January 2024 but only for the court to block it.

However, it is not late for the deductions and contributions to be effected this month.

The mandatory requirements of the law come as the government seeks to drive compliance and generate revenue by targeting at least 17 million Kenyans above 18 years who are not members of the NHIF to finance the Universal Health Coverage for all.

The new look SHIF seeks to ramp up resources for the government rollout of the UHC scheme for key services.