PhilHealth vows to reduce premium contributions, boost benefits

MANILA, Philippines — As several lawmakers criticized the Philippine Health Insurance Corporation (PhilHealth) for earning from investments while it shouldered only a small amount of its members’ hospitalization rates, PhilHealth officials have vowed to lower premium collections while increasing the benefits package.

At the hearing of the House of Representatives committee on good government and public accountability, Ako Bicol party-list Rep. Raul Angelo Bongalon asked PhilHealth president and chief executive officer Emmanuel Ledesma if he could also commit to lower premium rates contributed by members.

Bongalon asked this after Ledesma said that coverage would increase by 50 percent for several benefit packages.

“Can we ask the commitment of the President of PhilHealth?  Because you are saying now, which we appreciate, that by next month coverage will increase by 50 percent. But you failed to fulfill the second mandate,” Bongalon said during PhilHealth’s briefing regarding its zero government subsidy under the proposed 2025 national budget.

“That’s your mandate, so can you commit that you would not only be focused on benefit expansion but also commit towards decreasing the premium contribution?” Bongalon asked.

Ledesma then said that PhilHealth had intended to recommend a decrease in contributions, possibly going down from the current 5 percent to 3.25 percent of a member’s earnings.

“I actually made a commitment to sit down with my team in PhilHealth to recommend for a decrease in the premium contributions,” Ledesma said.

“We are fully supporting that reduction. And that is a very huge reduction po,” he added.

Bongalon’s questions came after PhilHealth was scolded for appearing to place too much focus on investments when its primary mandate should be to provide financial support for those acquiring healthcare services.  Committee chair and Manila 3rd District Rep. Joel Chua pointed this out after PhilHealth said that funds from investments are currently at P490 billion.

“Does this mean that the subsidy that the government supposedly provided for healthcare use was inserted into investments, and not healthcare?” Chua asked.

“Once we are done, after paying our benefits already, the excess money will be inserted into investments,” PhilHealth chief financial officer Renato Limsiaco said.

“It seems we are too focused on the investment aspect while we fail to give attention to our healthcare service.  Healthcare benefit, instead of investments. Here, our investments are the lives of the people,” he added.

Bongalon also noted that the law states that excess funds should be used to increase program benefits.

“It’s clear in the law […] when there are excess funds, these should be used, number one, to increase program benefits; and number two, to decrease the amount of contribution of the members,” he noted.

Congress was scrutinized recently after the bicameral conference committee tackling the proposed 2025 national budget decided to reallocate the P70 billion subsidy for PhilHealth.  Over social media, several individuals expressed concerns with PhilHealth, as it was given zero government subsidy for 2025 — with some fearing that the insurer would not be able to assist them if they get sick.

However, lawmakers clarified that the absence of an allocation from the General Appropriations Bill did not mean that PhilHealth would not have any funds, as it has P600 billion in surplus.

READ: Bicam asked: Restore budget of PhilHealth

Earlier, Ledesma said PhilHealth has surplus funds of P150 billion, a reserve fund of P280 billion, and an investment fund of P490 billion. Ledesma did not provide a total, but his figures show PhilHealth has P920 billion.

However, the reserve fund is not usually used to pay off benefits, which means that it has P640 billion to spend for 2025.

Still, the Philhealth chief said that the state-run insurer was “healthy” and could support the benefits payout of its members and beneficiaries for 2025.

Marikina 2nd District Rep. Stella Quimbo meanwhile called out Ledesma for ignoring her calls to reduce premiums.

READ: Quimbo: PhilHealth profit is too high, but benefits members get are too low  

“During the previous budget hearing, I reminded him (Ledesma) about this because PhilHealth has so much funds, I called for the reduction of premium contributions […] This year, I made the same call during the budget hearing, I said that there is already a scope to reduce premiums, but our call was ignored,” she noted.