DOH: PhilHealth benefits assured with or without GAA subsidy

Teodoro Herbosa —PCO PHOTO

The Department of Health (DOH) on Friday said benefits provided by Philippine Health Insurance Corp. (PhilHealth) would continue with or without a subsidy from the 2025 national budget, which was approved by the bicameral conference committee on Wednesday.

All of PhilHealth’s inpatient, outpatient and special benefit packages “will continue be available,” the DOH said, adding that it was “confident” that PhilHealth had the cash on hand to continue and even improve to benefit delivery in the next two to three years.

“The job of PhilHealth is to pay the health benefits of its members, with or without subsidy from the General Appropriations Act (or national budget bill). We reviewed the financial statements of PhilHealth together with its established performance, and the DOH is confident that it has enough money to continue and even improve operations,” a statement quoting Health Secretary Teodoro Herbosa as saying.

Unused reserve funds

Several senators had disclosed that the committee that reconciled the House and Senate versions of the budget bill decided to scrap the P74-billion subsidy for PhilHealth in 2025.

READ: PhilHealth’s zero subsidy for 2025 an insult to members – group

To explain this, Sen. Grace Poe, chair of the Senate finance committee, said the state health insurer had not been spending the allotment it received yearly from Congress, which prompted the Department of Finance earlier this year to order the remittance of PhilHealth’s P89.9-billion “excess funds” to the national treasury.

She also said PhilHealth still had P600 billion in reserve funds that it needed to use first.

According to the DOH, PhilHealth’s total benefit spending in 2023 amounted to P74 billion. From Jan. 1 to Sept. 30, with just three remaining months to the year-end, benefit spending has been estimated to be at P135 billion.

At the end of 2023, PhilHealth’s accumulated net income was pegged at P463.7 billion.

Improved benefits

Under the Universal Health Care Act, PhilHealth has secured a reserve fund of P280.6 billion, which the DOH said would be two years’ worth of benefits and other operating expenses.

PhilHealth’s surplus fund balance was at least P183.1 billion at the start of 2024, it added.

The department noted that since August, the PhilHealth board had approved new or improved benefit packages for hemodialysis, peritoneal dialysis, dengue, PhilHealth Konsulta and heart attacks.

It has also approved the rollout of benefits for rare diseases, oral/dental health, physical medicine and rehabilitation, including assistive devices like wheelchairs, and kidney transplantation.

Five more benefits are up for approval before the Christmas break, including those for emergency care, eyeglasses for children, open heart surgery, heart valve repair or replacement, and cataract extraction for children, plus another round of increase in case rates. —Jerome Aning INQ