Dela Cruz, Angeline F.

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News:
Unless stopped by Palace, PhilHealth premium hike proceeds

Rhodina Villanueva - The Philippine Star

January 13, 2024 | 10:00am

Individuals continue to avail services as face-to-face operations and transactions

continue at the Philippine Health Insurance Corp. (PhilHealth) in Quezon City on
September 26, 2023.
MANILA, Philippines — The Philippine Health Insurance Corp. (PhilHealth) has started
implementing the increase in premium contributions this month, in the absence of an
order from Malacañang stopping the hike.
“We have not received any message or directive from Malacañang so we are just
following the law. We already started implementing the increase,” PhilHealth president
and chief executive officer Emmanuel Ledesma Jr. said at a press briefing.
“If ever there is a directive or instruction from Malacañang, we will comply, but as of
today, there is none,” he added.
But he warned about the consequences of suspending the increase.
“If this will be suspended by the President, that would mean minus P17 billion from
PhilHealth’s fund for the year. With our current cash position and with the help we’re
getting from other agencies, I think that things will still push through as expected and I
don’t think it will affect us. We’ll be fine,” Ledesma said.
He said the hike in premium contributions this year will be the last.
“I’m taking this from the premium contribution, Section 10 of Republic Act 11223 – just
for the information of all of you, this increase of five percent in premium rate for this year
will be the last increase,” Ledesma said.
“So in 2025 onwards, there will be no more increase,” Ledesma added.
The increase took effect on the first day of the year. The five percent increase applies to
members earning between P10,000 and P100,000.
PhilHealth has also advised its members to ensure that their contributions are updated
for their membership to remain active and for them to enjoy continued health care
benefits.
As provided for under the Universal Health Care (UHC) law, premium contribution rose
to three percent in 2020, 3.5 percent in 2021, four percent in 2022 and 4.5 percent last
year.
In 2021, however, PhilHealth suspended the rate hike of three percent to 3.5 percent
amid the COVID-19 pandemic.
PhilHealth said the increase for this year would mean P500 contribution from those
earning P10,000 a month and P5,000 from those with monthly income of P100,000 or
more.
Meanwhile, Ledesma also said PhilHealth has already paid a total of P46.5 billion in
arrears to both public and private hospitals.
“Of the P46.5 billion we paid out starting August (last year) up to now, payment made to
private health facilities amounted to P26.2 billion. That translates to 56 percent,”
Ledesma said.
As to government hospitals, the PhilHealth chief said P20.3 billion has already been
paid. “This translates to roughly 44 percent,” he added.
“From August, September, October, November, December – five months, the total
payment was P45 billion,” he pointed out.
It was October last year when PhilHealth revealed having settled a total of P20.651
billion of its outstanding debt to hospitals amounting to P27 billion.
Despite the cybersecurity incident in September, Ledesma said they were able to
bounce back and manage to process payables.
“We appeal to our partner health facilities to submit good claims and comply with the
policies to avoid return or denied claims for we are bound by auditing rules and
regulations of the government,” Ledesma maintained.
Reference:
Villanueva, R. (2024, January 13). Unless stopped by Palace, PhilHealth premium hike
proceeds. PhilStar. https://www.philstar.com/headlines/2024/01/13/2325468/
unless-stopped-palace-philhealth-premium-hike-proceeds

Insights:
Based on employees’ basic salary, employers and employee equally shared the
premium contributions, especially PhilHealth. The Electronic Premium Remittance
System (EPRS) automatically deducted these monthly premium contributions to the
employees’ salaries. With this contribution, Filipino citizens are protected as the health
insurance program will offer comprehensive healthcare services, giving special attention
to the requirements of the underprivileged, ill, old, disabled, women, and children.
Additionally, indigents will receive free medical care. PhilHealth provides all Filipinos
with high-quality healthcare services that are available, affordable, and accessible.
In 2023, PhilHealth contribution premium rate is 4% which is deducted to all
employed Filipino citizens in the Philippines. However, this premium rate contribution is
not enough to sustain PhilHealth funds for the Filipinos in both public and private
hospitals. To protect all the members and beneficiaries of the PhilHealth, an increase to
5% premium contribution rate is applied since the start of the year. Employees who are
members of PhilHealth making P10,000 or more a month will be required to make a
P500 contribution, while those making P100,000 or more will be required to make a
P5,000 contribution. From August to December in the year 2023, PhilHealth has already
paid a total of P46.5 billion in arrears to both public and private hospitals. As stated by
PhilHealth president and chief executive officer Emmanuel Ledesma Jr., if Malacañang
didn’t respond to the increasing hike of PhilHealth premium contribution, in Section 10
of Republic Act 11223, the recent hike of premium contribution will be the last increase.
In contrast, the PhilHealth funds would lose P17 billion in 2024 if the increase is
suspended by the President. Therefore, an increase of the premium rate will improve
the well-being and health of every member, whether preventive or therapeutic in nature,
are greatly strengthened and sustained by PhilHealth funds.