House of Representatives (Ellson Quismorio/ MANILA BULLETIN)

The Philippine Health Insurance Corporation (PhilHealth) has vowed to the House Committee on Good Government and Public Accountability that it would reduce members’ contribution rate from 5 percent to 3.25 percent while also expanding hospitalization coverage by 50 percent. 

PhilHealth President and Chief Executive Officer (CEO) Emmanuel Ledesma Jr. gave this commitment Tuesday, Dec 17 in response to solons’ concerns that the agency must better utilize its substantial reserve funds for the direct benefit of its members.

The backdrop of all of these is the brouhaha over the lack of government subsidy for the state health insurer under the proposed P6.352-trillion General Appropriations Bill (GAB) or national budget next year.

Majority congressmen have repeatedly said that this isn't something to worry about, given all the money that PhilHealth has in its back pocket.

PhilHealth’s surplus funds stand at P150 billion, while its reserve funds exceed P200 billion.

House Assistant Majority Leader Ako Bicol Party-list Rep. Jil Bongalon sought PhilHealth’s assurance that members’ contributions would be decreased, given the agency’s surplus funds. 

“Can we ask the commitment of the President of PhilHealth? Kasi sinasabi niyo po ngayon, which we appreciate, kasi by next month tataas ng 50 percent [ang coverage]. But you failed to fulfill the second mandate,” Bongalon said.

(It's because you're saying right now, which we appreciate, because by next month the coverage will increase by 50 percent.)

He noted that PhilHealth’s mandate includes decreasing contribution rates once reserve funds exceed the ceiling needed to meet expenditures.

“So can we commit, can you commit na hindi lang kayo nakatuon or naka-focus doon sa benefit expansion. But can you commit also na i-decrease niyo yung premium contribution?” Bongalon added.

(Can you commit that you just weren't focused on benefit expansion. But can you commit also to decrease your premium contribution?)

Ledesma confirmed PhilHealth’s intention to recommend a decrease in contributions, in line with a pending Senate measure to reduce the rate from 5 percent to 3.25 percent.

“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.

The official explained that premium rates are set by law and that PhilHealth does not unilaterally decide increases. He also assured lawmakers of the agency’s full backing of proposed reforms that benefit members.

PhilHealth’s commitment to reduce rates was complemented by its pledge to committee chairman Manila 3rd district Rep. Joel Chua to increase healthcare benefits. 

“With this, PhilHealth, lalong dadagdag po sana ‘yung tulong (you should increase the actual assistance),” Chua said as he emphasized the struggles of indigent constituents burdened with high hospital bills.

He highlighted that healthcare remains the number one concern for lawmakers’ constituents. 

The Manila solon urged PhilHealth to focus on its core mandate of expanding benefits rather than prioritizing investments. 

Ledesma responded by saying: “Ang commitment namin is to increase the program benefits, which hopefully mag-take effect by next month.”

(Our commitment is to increase the program benefits, which hopefully would take effect by next month.)