NHIF is now SHIF: What to know as gov’t plans to deny services to Kenyans without SHIF membership proof

Kenyans on Monday, November 20 woke up to the news that the Health Cabinet Secretary Susan Nakhumicha is set to gazette regulations to operationalise the Social Health Insurance Act and those without SHIF membership proof will be denied government services.

“A person who is registrable as a member under this Act shall produce proof of compliance with the provisions of this Act on registration and contribution as a precondition of dealing with or accessing public services from the national and county governments,” the regulation stated in part.

Here are essential things to know about the new health insurance program (SHIF) under President William Ruto’s administration.

1. For starters, President Ruto signed into law the Social Health Insurance Bill on October 19. This meant the replacement of the National Health Insurance Fund with the Social Health Authority (SHA).
2. The Social Health Authority is set to manage the new Social Health Insurance (SHI) scheme and oversee three funds: Social Health Insurance Fund (SHIF), Primary Healthcare Fund, and Emergency, Chronic and Critical Illnesses Fund.
3. Funding of SHIF is stipulated to come from premium contributions from the formal and informal sectors. The other two funds will be financed by the government through taxes, donations, and gifts.
4. All Kenyans above 18 years old are now required to become members and contributors to the SHIF. Employees in the formal sector, private and public, will contribute 2.75% of their salary to the health fund, while those in informal employment will part with up to KSh 500 per month towards the scheme.
5. The government will continue providing health insurance subsidies to orphans, vulnerable and people with severe disability based on data provided by the State Department for Social Protection and to people experiencing extreme poverty.
6. The aim of the new insurance scheme is to get 85 percent of the population under the fund.

The formation of the Social Health Authority has expanded the coverage of the national health insurance scheme to include resources for emergency, chronic, and critical illnesses; thus, improving access to intensive care and high-dependency units for many Kenyans who may not afford the payments.