Kenyans with irregular sources of income could soon be allowed to take loans from the Hustlers Fund to pay for their Social Insurance Fund (SHIF) under the proposed changes by the government.

The Insurance Premium Financing (IPD) under the Hustlers’ Fund will mainly target individuals in the informal sector. The government says it has been forced to review the Social Health Authority (SHA) scheme after a public outcry due to
the inherent challenges.

After a false start on Universal Health Coverage (UHC) implementation, the government also announced changes to the Means Testing Improvement (MTI) targeting informal sector, revealing that a new MT algorithm is being developed.

Interestingly, the new MTI will rely more on data triangulation from other existing data bases in government agencies
for improvement of the accuracy of the MT model.

Fresh categorisation

Under new MTI, the government will categorise Kenyans afresh and thereafter plug in the Insurance Premium Financing
(Hustlers Fund) to support households with irregular sources of income.

Part of the proposed reforms is the proposal to increase funding for the Intensive Care Unit (ICU) from the current daily
refund of Sh4, 448 to Sh28, 000 per day with immediate efect as an additional funding through the supplementary budget.

“An additional Sh150, 000 is also being proposed to increase the Oncology package from Sh400, 000 to Sh550, 000 per
household per year,” said Health Cabinet Secretary Deborah Barasa

Dr Barasa explained that the additional funding was reached after a review of the benefits and tarifs, which will go through
the legal processes for gazettement.

Among other benefits to be increased are the optical which have been at the rate of Sh2,000 per household per year, ambulance services and review on the overseas treatment from the current Sh500,000 all-inclusive.

Among other issues, the government proposes to employ an additional 2000 doctors, establishment of mandatory staffing norms for various levels and categories of hospitals under a new Human Resource Health policy within the next 90 days.

Public outcry

Yesterday, State House’s Secretary of Public Communications and Media Liaison Munyori Buku Munyori told the
People Daily that the government has decided to undertake the reforms as a result of the public outcry over some of the
shortcomings in SHA.

To facilitate access to healthcare, Munyori said the government will provide funds for payment of old National Hospital Insurance Fund (NHIF) debts including civil servants scheme.

The government will also provide additional funding for improvement of benefits package. But the State house propelled reforms appear to have received lukewarm response from Afya House and SHA where the top brass denied knowledge of the initiative.

While State House circulated a document enumerating the proposed reforms that it said emanated from public feedback, Ministry of Health officials and SHA top brass claimed they were not aware of the proposals.

A document sent to newsrooms by State House indicated that the government has introduced changes to some of the components in SHA in a bid to jump-start the faltering implementation of the Universal Health Coverage (UHC).

On Monday, Barasa, while making the presentation containing the proposals during the inaugural health summit at the Deputy President’s official residence in Karen, revealed that the Supplementary Budget was to be tabled before the National Assembly yesterday.

Barasa pointed out that the ministry has already requested data from government institutions including Kenya National Bureau of Statistics (KNBS), Kenya Revenue Authority (KRA), Immigration Department, Hustler Fund/Communication Authority- CA, Registrar of Companies, Kenya Power; the Insurance Regulatory Authority- IRA.

Others are the National Transport and Safety Authority- NTSA, Ministry of Cooperatives, Ministry of Land/ KenyaIntegrated Agricultural Management Information System- KIAMIS.

”Once the new Means Testing instrument is ready we shall plug in the Insurance Premium Financing to support households with irregular sources of Income,” the CS stated, revealing the focus will be on the informal sector enrolment through organized groups such as cooperatives and other organised groups including Boda Boda operators, an estimated 4.3 million Jua Kali artisans and one million (1m) drivers and conductors.

But yesterday, SHA chairman Abdi Mohamed said he was not aware of the proposals, which he said had only seen them being flouted at the meeting like everyone else in attendance.

Barasa and Medical Services PS Harry Kimtai declined to comment on the proposals, with sources in the ministry indicating the reforms were a “State House affair.”

“The ministry was neither consulted nor involved in the proposals. Not even the top brass at SHA are aware of the proposals,” said a senior medic in the ministry who declined to be named due to the sensitivity of the issue.

The Social Health Insurance (SHI) Act provides for overseas purchase of healthcare services not available locally.

According to Barasa, the government continues undertaking for overseas treatment through SHA Tarif for overseas is
Sh500, 000 all inclusive.

In this view, last week the ministry established a Benefits Package and Tariffs Advisory Panel (BPTAP) to effect the review of the Benefits Package and Tariffs every 2 years.

“The University of Nairobi through the Centre for Epidemiological Modelling and Analysis will host the Panel and Joint Secretariat,” the CS revealed, announcing that the vetting of the Panel’s nominees CVs was going on.

In respect of the above changes, Barasa appealed for funding to pay of the old National Health Insurance Fund (NHIF) debts including civil servants scheme, to facilitate access to healthcare services.

“We are also asking the counties to plug in additional funding for improvement of benefits package; identification and financing for indigent population,” the CS said.

The Ministry is also asking for the Insurance Premium Financing (IPF) implementation to support the informal sector enrolment, and support in rapid registration initiatives for SHA registration and premium payment in the Counties.