Senate President Francis “Chiz” Escudero said the Philippine Health Insurance Corporation (PhilHealth) can afford to lower its members' mandatory contribution thanks to the huge chunk of unutilized funds that it has accumulated over the years.

Citing figures from the Department of Finance (DOF) that the reserve fund of PhilHealth has reached close to P500 billion on top of its the substantial annual government subsidy, Escudero says there is more than enough resources to cover for a reduction in the premium contributions of its members.

“May mahigit kumulang P500 billion pa silang sobrang pera na pwedeng i-absorb kaugnay sa pagbabayad nga ng buwanang premium. Ang total subsidy ng pamahalaan para sa premium kada taon ay humigit kumulang P70 billion (They have estimated surplus funds of P500 billion that they can absorb for the payment of monthly premiums. The government's total subsidy for the premium annually is more or less P70 billion),” Escudero said.

The national government provides an annual subsidy to PhilHealth for the implementation of the National Health Insurance Program, primarily to cover for the premiums of the indirect contributors that include indigents and senior citizens.

In 2021, the subsidy to PhilHealth amounted to P71.3 billion. This went up to P80 billion in 2022, P79 billion in 2023 and for this year, it was down to P40.3 billion.

Escudero pointed out that the huge subsidies allocated annually to PhilHealth, coupled with its continually increasing reserve fund, provide the state health insurer ample room to reduce the premium rate of its members.

Assuming the average subsidy to PhilHealth is at P70 billion, Escudero argued that the government would still be able to reallocate a significant amount of funding for other purposes for seven years if the said subsidies were to be sourced from the firm’s reserve fund.

“Pero imbes na gawin ‘yon, isa sa mga istratehiya na pwede nilang pag-aralan ay ang gamitin na lang (ang reserve fund) para pababain yung premium na karamihan naman ay gobyerno rin ang nagbabayad (However, instead of doing that, one strategy they can study is to simply use the reserve fund to lower the premium, which is often paid by the government in the first place),” Escudero said.

The Senate President has been pointing out to PhilHealth that it is losing around P20 billion a year in terms of value by not utilizing its P500-billion reserve fund.

“Kaya para sa akin mas maganda na gamitin ang perang ‘yan para matulungan ang ating mga kababayan sa pamamagitan ng dagdag na serbisyong medical o sa pagbaba sa binabayaran nilang premium (That's why for me it's better to use that money in order to help our countrymen get additional medical service or in lowering their premium payments),” Escudero said.

The Senate has already approved the bill seeking to amend Republic Act (RA) No.11223 or the Universal Health Care (UHC) Act in order to bring down the premium rate for direct contributors of PhilHealth.

Under Senate Bill (SB) No. 2620, PhilHealth’s premium rate will go down to 3.25 percent from the current 5 percent. This will gradually be increased to 3.5 percent in 2026, 3.75 percent in 2027, and 4 percent in 2028.

The bill is now with the House of Representatives, which has on its table two different measures seeking to amend the UHC Act.

Escudero is also pushing for PhilHealth to adjust its case rates based on the amount of contributions paid by its members.

Just like with other insurance products, Escudero said members who pay bigger premiums should be entitled to higher case rates, if and when they require medical attention.