House to push for PhilHealth contribution pause if funds are stable

MANILA, Philippines — The House of Representatives will push for a one-year suspension of Philippine Health Insurance Corporation (PhilHealth) contributions if it is deemed that the state-run insurer’s finances are healthy, Speaker Ferdinand Martin Romualdez said on Wednesday.

In his speech before the House adjourned its session, Romualdez said the legislative chamber would start an investigation into PhilHealth in 2025 to check if funds are being managed properly.

“Next year, the House of Representatives will also conduct a thorough and impartial investigation into how PhilHealth’s funds are being managed.  This investigation is not about blame; it is about finding solutions.  Our goal is clear: to ensure that every peso in PhilHealth’s coffers works for the benefit of its members — the hardworking Filipino people who contribute month after month,” he said.

“If funds remain stable and in surplus, we will recommend a one-year suspension of premium payments for all paying members.  This will serve as a form of relief to millions of Filipinos already grappling with inflation and rising prices,” he added.

According to Romualdez, the House will do this because PhilHealth’s primary mandate should be to help people during medical emergencies.

“Our goal is clear: to ensure that every peso in PhilHealth’s coffers works for the benefit of its members — the hardworking Filipino people who contribute month after month,” he said.

“Why are we doing this? Because the Filipino deserve no less.  PhilHealth exists to provide security and comfort in times of medical emergencies.  It should not hoard resources at the expense of its members.  If we can alleviate the burden of contributions without compromising its sustainability, we will do so,” he noted.

Romualdez also noted that if the investigation reveals that PhilHealth funds are not maximized, the House will demand the expansion of benefits packages and eventually reduce contributions without affecting the insurer’s services.

“If this investigation reveals that existing funds are being underutilized or are in excess of what is needed for current operations, we will pursue the following recommendations: one, further expand benefits for members until we reach the vision of zero billing all in hospitals.  We will also ensure that PhilHealth provides expanded healthcare coverage, including additional medical services, hospitalization support, and better benefits for those in need,” he said.

“Number two, further reduce premium contributions for workers and employers burdened by rising costs, we will explore reducing premiums while maintaining PhilHealth’s capacity to deliver its services,” he added.

Congress was scrutinized recently after the bicameral conference committee tackling the proposed 2025 national budget decided to remove the over P70 billion government subsidy for PhilHealth.

Over social media, several individuals expressed concerns about the lack of subsidy, with some fearing that the insurer would not be able to assist them if they got sick.

However, House 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.

On Tuesday, PhilHealth president and chief executive officer Manuel Ledesma told the House committee on good government and public accountability that the state-run insurer was financially healthy, as it has surplus funds worth 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, since the reserve fund is usually not used to pay off benefits claims, PhilHealth would have P640 billion to spend for 2025.

Due to this, lawmakers scolded PhilHealth for seemingly prioritizing investments over providing healthcare support for its beneficiaries and members.  Marikina 2nd District Rep. Stella Quimbo, in particular, called out Ledesma for ignoring her calls to reduce premiums.