NHIF to continue as state suspends launch of new health cover

The government has shelved the roll out of the much-awaited health benefits under the social health insurance, until October.

The postponement follows delays occasioned mainly by the new ICT system that will support the new health regime. It had been tested several times before last week but was not ready. The verification of assets owned by the NHIF is also incomplete.

The ministry also delayed the validation and gazettement of the new benefits package.

Health Cabinet Secretary Susan Nakhumicha said on Friday that the National Health Insurance Fund (NHIF) will now continue until October.

She mainly blamed the withdrawal of the Finance Bill.

The Bill had, for the first time, allocated about Sh6 billion to two critical funds that have been formed to support the Social Health Authority.

“In light of the withdrawal of the Finance Bill, 2024 that sought to finance the Primary Healthcare Fund and the Emergency, Chronic and Critical Illness Fund and set aside funds for indigents and vulnerable persons, the ministry is reworking to align to this reality. Therefore, the existing NHIF contributions and benefits will continue until we roll over to SHA,” she said at a press briefing at Afya House.

The ministry published the proposed SHA benefits package two weeks ago and asked Kenyans for their views before the package is gazetted. 

According to the law, SHA benefits should begin on July 1.   The Social Health Insurance (General) Regulations, 2024, says registration of members should be completed by June 30 and health services under the Act begin July 1.

“The SHA Act requires the design and publication of a new benefit package. We have, through a consultative process, developed and recently advertised the tariffs and benefit package for public participation and stakeholder input. Feedback has been incorporated ahead of a national validation and formal gazettement before the roll out,” Nakhumicha said on Friday.

She added that there are other pending issues, including the fact that health facilities that will offer services have not been contracted. Contracting can only happen when the benefits package is clear.

“The Social Health Authority board has requested and received from the regulatory bodies the list of empanelled facilities that will facilitate the SHA board to initiate contracting for purposes of service delivery ahead of the roll out,” Nakhumicha said.

The postponement of SHA rollout follows delays and cancellations of key activities that should have happened in the last two weeks.

For instance, a calendar of events showed a national validation exercise was to take place on June 21 at the Kenyatta  International Conference Centre, but it did not.

The launch of SHA registration was expected to follow on June 21 at Uhuru Park but did not.

The CS said the registration would now begin next week.

“I hereby announce that registration shall commence from 1 July 2024. This will be conducted countrywide through self registration by use of a USSD *147# or www.sha.go.ke,  assisted registration by Community Health Promoters, visiting the NHIF Offices and other registration points as the SHA board will designate. Please note that registration is free,” she said.

The SHA Act was enacted on October 19 last year and came into operation on November 22, 2023 (appointed day), and gave twelve months period to wind up the NHIF.

Two weeks ago, the team managing the transition from NHIF to SHA said the continued use of NHIF systems past July 1 will have financial implications, because the licences and contracts for the NHIF system need to be renewed.

They said the Sh8 billion digital system on which SHA will operate was not even ready.

“The ICT SHA system was piloted in Marsabit. Dry runs revealed that the new system was not ready and challenges are being addressed and a second repeat dry run that encompasses proxy mean testing may be done thereafter,” the team said in its meeting on Friday last week.

Section 47 of the Social Health Insurance Fund requires that digitisation and processes be done using a secure, interoperable, verifiable and responsive technology through an information system.

The system supports registration of members, member identification, contributions to the Fund, empanelment of facilities, execution of contracts, notification and pre-authorisation, claims management and settlement of claims.