PhilHealth commits to lower members’ contribution rates, expand hospital coverage by 50% next month
DESPITE the absence of government subsidy, the leadership of the Philippine Health Insurance Corporation (PhilHealth) on Tuesday made a commitment to members of the House of Representatives to reducing members’ premium contribution rates from five percent to 3.25 percent while also expanding hospitalization coverage by 50 percent.
PhilHealth President and CEO Emmanuel Ledesma Jr. made the commitment during Tuesday’s Blue Ribbon Committee hearing in response to lawmakers’ concerns that PhilHealth must better utilize its substantial reserve funds for the direct benefit of its members.
House Assistant Majority Leader and Ako Bicol Party-list Rep. Jil Bongalon sought PhilHealth’s assurance that members’ contributions would be decreased, given the agency’s surplus funds.
“Can we ask the commitment of the President of PhilHealth? Kasi sinasabi nyo po ngayon, which we appreciate, kasi by next month tataas ng 50% (ang coverage). But you failed to fulfill the second mandate,” Bongalon said.
He stressed that PhilHealth’s mandate includes decreasing contribution rates once reserve funds exceed the ceiling needed to meet expenditures.
“Yun hong mandato ninyo eh. So can we commit, can you commit na hindi lang kayo nakatuon or naka-focus doon sa benefit expansion. But can you commit also na i-decrease nyo yung premium contribution?” Bongalon added.
In response, Ledesma confirmed PhilHealth’s intention to recommend a decrease in contributions, aligning with a pending Senate measure to reduce the rate from 5% to 3.25%.
“I actually made a commitment to sit down with my team in PhilHealth to recommend for a decrease in the premium contributions,” Ledesma said.
“We are fully supporting that reduction. And that is a very huge reduction po,” he added.
Ledesma explained that premium rates are set by law and that PhilHealth does not unilaterally decide increases.
“Lahat yan nakaset po. And then just for the information of this honorable body, it’s currently at 5% this year. Yan po yung huling increase,” Ledesma explained, assuring lawmakers of their full backing for reforms that benefit members.
Bongalon also questioned PhilHealth’s allocation of government subsidies, noting that funds intended for indirect contributors appear to have been diverted to investments.
“Same with the 2024 GAA. Ang budget ng PhilHealth ay P60 billion, P40 billion doon ay para sa indirect contributors. So hindi ho natin maintindihan kung bakit napupunta lahat sa investments,” Bongalon said.
PhilHealth’s commitment to reducing rates was complemented by its pledge to increase healthcare benefits, addressing concerns raised by Manila Rep. Joel Chua, panel chairman.
“With this PhilHealth, lalong dadagdag po sana ‘yung tulong,” Chua said, emphasizing the struggles of indigent constituents burdened with high hospital bills.
Chua highlighted that healthcare remains the number one concern for lawmakers’ constituents.
“Kasi, for example, ma-confine ka sa Heart Center, ang bill mo isang milyon. Saan naman kukuha ng isang milyon mga constituents namin?” Chua asked.
He urged PhilHealth to focus on its core mandate of expanding benefits rather than prioritizing investments.
“Kaya sana, ito pong PhilHealth, mag-focus tayo sa … healthcare benefits instead sa investments … kasi dito ang investment natin dito ay buhay ng tao,” Chua said.
Ledesma assured lawmakers that PhilHealth remains committed to increasing program benefits, saying, “Ang commitment namin is to increase the program benefits, which hopefully mag-take effect by next month.”
PhilHealth’s surplus funds, which stand at P150 billion, and reserve funds exceeding P200 billion, remain a key concern.
Lawmakers stressed the importance of balancing financial sustainability with tangible benefits for members.
Ledesma’s commitment to both reducing contribution rates and expanding healthcare benefits was welcomed by lawmakers, who vowed to monitor PhilHealth’s progress.
