Consider six-month suspension on higher premiums, Defensor urges PhilHealth

This file photo shows Anakalusugan Rep. Mike Defensor during a briefing at the House of Representatives. INQUIRER.net file photo / Noy Morcoso

MANILA, Philippines — Citing “fortuitous event,” Anakalusugan Rep. Mike Defensor said the Philippine Health Insurance Corp. (PhilHealth) should consider a six-month suspension of the increase in premium contributions.

Defensor, who serves as the vice chairperson of the House committee on health, said that PhilHealth members deserve a temporary reprieve from the increase in premium contributions amid a “fortuitous event” such as the coronavirus pandemic.

“We are in the middle of a once-in-a-century pandemic. Even private preneed companies are declaring a ‘fortuitous event’ to justify delays in the payment of their contractual obligations to thousands of planholders,” Defensor said in a statement.

“Surely, PhilHealth members also deserve a temporary reprieve from the half percentage point increase in premium contributions,” he added.

If necessary, Defensor said Congress should pass a joint resolution calling for the six-month deferment of the increase in premium contributions.

Defensor likewise pointed out that PhilHealth’s reserve fund stood at P110 billion as of March 2020. The surplus from premium contributions less claims and administrative expenses goes straight to the reserve fund.

“In an extreme situation wherein claims  and administrative expenses might exceed contribution collections due to the pandemic, PhilHealth can always dip into its Investment Reserve Fund and the earnings thereof,” Defensor said.

Further, the lawmaker said that there is a need  for PhilHealth to reduce internal financial losses due to excessive and fraudulent claims, mostly by private hospitals, outpatient service providers and physicians.

Republic Act No. 11223, or the Universal Health Care (UHC) Act, mandates increases in member premiums by increments of 0.5 percent every year, starting 2021 until it reaches the 5-percent limit in 2025.

For 2021, the premium rate will increase to 3.5 percent of monthly basic salary from 3 percent in the previous year.

Despite calls for suspension of the hike, PhilHealth said it would start collecting the mandated hike in members’ contributions this month.

JPV