Concerned over the apparent confusion gripping the National Health Insurance Fund (NHIF), several government agencies are now migrating their medical insurance services to private firms.

NHIF board, chaired by former Transport and Infrastructure Cabinet Secretary Michael Kamau, has convened a crisis meeting this morning to discuss the transition from the entity to the three newly formed social health agencies.

The development follows the disbandment of the NHIF enhanced scheme for civil servants and parastatals following the enactment of the Social Health Insurance Fund (SHIF) that replaced the former national health insurer.

SHIF has removed the provision for enhanced covers that civil servants, public officers and employees of various government agencies have been enjoying over the years.

And even as parastatals and several other government agencies shop around for better medical insurance packages from private firms for their staffers, several hospitals are turning away NHIF card holders over non-payment of capitations.

A number of health facilities are now insisting on cash for services rendered after NHIF defaulted on refunds as they send away patients with the national health insurer.

Protesting development

“All these issues will be addressed at today’s meeting and a statement issued thereafter. We are aware of all the challenges that have come up as a result of the new Acts,” Engineer Kamau told the People Daily by telephone.

Kenya Medical Practitioners, Pharmacists and Dentists Union Secretary General Davji Atellah now says they have written to the government protesting the development.

“All this money that government agencies intend to pay private insurance firms should be used for other purposes in the Universal Health Cover (UHC), Dr Atellah told the People Daily.

According to Dr Atellah the government should reconsider Section 5 of the Transition Schedule that outlaws the enhanced medical cover for civil servants.

“It is illogical for the government to revoke the NHIF comprehensive medical cover that has been of immense benefit to public officers while at the same time spending millions of shillings to bring on board private insurance firms to provide the same service,” Atellah said.

Among the first government agencies to have sought for a medical cover from a private firm for its staffers was the National Police Service (NPS) and Kenya Prisons Service (KPS) had on December 29, 2023 its contract with CIC and Britam for medical and group life covers for three months.

Vide letter NPS/IG/A/EST/7/40 Vol. IX/57, Inspector General of Police Japhet Koome informed the officers of the extension of the services for another three months.

“The National Police Service and Kenya Prisons Service has extended the contracts in respect of the above referred covers for three months as a new contract is being processed,” the letter stated.

The letter went on to state: “Inform all officers under your command to continue seeking medical services from respective CIC accredited health facilities and group life covers from Britam as usual.”

And in a letter dated December 29, 2023, Kenyatta National Hospital (KNH) also informed her staffers that NHIF would not renew the comprehensive medical cover that was to expire two days later.

“In this regard, employees are informed that the Hospital has procured the services of Britam Insurance to provide Comprehensive Medical Insurance Services to Hospital employees and their dependents. Britam will commence provision of these services with effect from January 1, 2024,” the letter signed by KNH Director of Human Resource Winnie Mwangi states.

Mwangi says KNH management made the decision to source for an alternative means to ensure employees are effectively covered upon the expiry of the NHIF cover “to forestall any disruption or vacuum in provision of this essential benefit to employees.”

Comprehensive cover

Several public universities and parastatals have already moved to source for alternative comprehensive insurance cover for their employees as the government prepares to launch SHIF.

Among the public institutions that have been benefitting from the NHIF comprehensive cover and are now in the process of sourcing for an alternative include universities- Moi, Alupe, Bomet, Kenyatta, Nairobi, JKUAT, Egerton, Kisii, Dedan Kimathi and Maseno- and parastatals- National Defence, KNH, Wildlife Research Institute, Nyayo Tea Zones Development Corporation, Kenya Power Pensions Fund, Water Resources Authority, Lapsset Corridor Development Authority, Kenya Veterinary Board, Coast Water Works Development Agency and National Social Security Fund (NSSF).

Also affected are millions of retired public officers and civil servants who have been relying on the scheme as almost all private medical insurance schemes do not offer them insurance due to age limit.

On Monday, various trade unions in the health sector met Health Cabinet Secretary Susan Nakhumacha where they also voiced their misgivings over the disbandment of the NHIF comprehensive cover without any replacement.

In attendance of the Monday meeting at Afya house were representatives of Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU), Kenya Union of Clinical Officers (KUCO), Kenya National Union of Nurses (KNUN), Kenya Union of Nutritionists and Dietitians (KUNAD) and Kenya National Union of Medical Laboratory (KNUML).

Already, NHIF has terminated EduAfya, a scheme that had benefited millions of secondary school students. Introduced in May 2018 by then President Uhuru Kenyatta, the Ministry of Education contracted NHIF to offer a unique comprehensive medical insurance cover for public secondary school students.

Through the cover, the government paid a premium of Sh1,350 per student, with NHIF pocketing Sh9.5 billion from the government over the last four years.

KMPDU Deputy Secretary General Denis Miskellah who attended the meeting told the People Daily that Nakhumicha had promised to take up the issue of scrapping the NHIF’s enhanced cover with the Public Service Commission (PSC) and other independent commissions such as the Teachers Service Commission (TSC).

“The issue has caused confusion in public service, particularly in the health sector where employees have for a long time been enjoying quality services from the NHIF comprehensive cover. We just hope that this is going to be addressed,” Dr Miskellah told the People Daily.