NAIROBI, Kenya Mar 7 – Members of Parliament have raised concerns that the newly enacted Social Health Insurance Fund (SHIF) is at risk of collapse due to unsustainable funding mechanisms.
Legislators are now demanding urgent reforms to secure the future of the national medical insurance scheme.
Appearing before the National Assembly Health Committee, Medical Services Principal Secretary Harry Kimutai revealed that only 3.9 million people were actively contributing to SHIF, despite the fund having 20.2 million registered beneficiaries.
The low contribution rates have alarmed lawmakers, who argue that the fund cannot sustain itself unless urgent measures are put in place to increase the number of contributors.
SHIF Funding Model Flawed
Committee Chair Robert Pukose (Tinderet MP) criticized the current funding structure, warning that without mandatory contributions, the scheme was doomed to fail.
“That’s a drop in the ocean. It will not make this fund sustainable. It will ultimately kill this fund. We must investigate mechanisms of making sure that Kenyans contribute to the fund. That’s a disaster in the making—is it even sustainable?” Pukose questioned.
Vice Chair Patrick Munene (Chuka Igambang’ombe MP) questioned the logic behind contributions, arguing that many Kenyans would opt out of paying premiums since they could still access free medical services upon registration.
“If I can receive treatment in level 2 and level 3 for free by merely registering, then why should I pay for the premium? I just need to register and that’s it. Even for the Emergency and Chronic Fund treatment, the requirement is that if I pay immediately, I receive treatment. Why should I pay?” Munene asked.
He further suggested that the government should revisit some aspects of the now-defunct NHIF model, which required mandatory contributions to sustain the fund.
“We need to crack our heads and think whether we need to borrow some clauses from NHIF; otherwise, we cannot run an insurance scheme like this,” he added.
Seme MP James Nyikal also raised concerns over the low contribution numbers, warning that without reforms, SHIF was headed for financial collapse.
“The issue of only 3.9 million Kenyans out of 20.2 million registered paying for the fund will only kill the fund,” Nyikal stated.
The revelations come amid growing concerns that SHIF’s financial model is unsustainable, with experts warning that unless more Kenyans enroll as contributors, the fund will struggle to cover medical costs for millions of beneficiaries.
Stakeholders’ view
These coming days after private hospitals alluded that SHIF would collapse in the next 12 months due to severe underfunding and flawed funding structure.
Kenya Association of Private Hospital Chairperson Erick Musau warned that only 4 million Kenyans were contributing to the SHIF kitty fund with the majority being on salaries.
Musau pointed out with no framework on ensuring the non-salaried employees who are the majority contribute to the fund, then the sustainability of the fund is in jeopardy.
“We do not feel that sufficient safeguards have been put up to ensure that people continuously contribute to this kitty and not just when they need services, and if this trend goes on like this, we do not see this fund surviving beyond 12 months,” he noted.
Kenya Healthcare Federation Chairperson Kanyenje Gakombe highlighted that 80 percent of those seeking treatment under SHIF register and pay at the point of need with no sufficient framework to compel them to pay premiums.