Planned PhilHealth premium reductions to affect 11 million members

MANILA, Philippines — The Senate’s plan to support reduction of premiums for the Philippine Health Insurance Corp.’s indirect contributors will affect close to 11 million PhilHealth members, according to a medical group.

“While PhilHealth sought to cover 25,229,307 indirect members next year, the Department of Budget and Management only recommended the coverage of 14,157,910 indirect members with a reduced budget of P53 billion in the 2025 presidential budget (for indirect members) already approved by the lower House,” Juan Perez III, co-chairperson of the Medical Action Group, said in a statement.

“This leaves out 10,981,036 indirect members without premium coverage in 2025,” he said.

Perez added that this year, Congress only approved P40 billion for the premiums of indirect members.

He said that with PhilHealth’s increasing case rates and benefits, claims for the indirect members are expected to increase to at least P80 billion in 2024, and P100 billion next year.

“If the Senate and House versions are approved, PhilHealth will only get P93 billion from 2024-2025 while claims are expected to balloon to over P180 billion in the same period,” he said.

“This will mean that the direct members’ contributions will have to shoulder the deficits caused by legislative non-compliance with the UHC (Universal Health Care) law, leading to accelerated losses in the PhilHealth reserve fund by 2028,” he said.