Senate Minority Leader Alan Peter Cayetano has called out the Department of Health (DOH) and the Philippine Health Insurance Corporation (PhilHealth) for misleading the public on the true scope of the No Balance Billing (NBB) policy.

According to Cayetano, the term “no balance billing” (NBB) does not reflect what patients actually experience on the ground.

During the Senate plenary debates for the proposed 2026 DOH budget, Cayetano flagged the inconsistency between the program’s name and its actual  implementation.

“Hindi ‘no balance’ iyon. Isn’t that false advertising?” the senator told Senator Pia Cayetano, sponsor of the DOH budget on Thursday, Nov. 27.

Cayetano said mayors, local health officials, and the public’s confusion has worsened following the President’s State of the Nation Address (SONA) last July, which suggested universal zero billing in public hospitals. He said many remain unclear about the exact coverage and rules. 

To clarify this issue, the Senate temporarily suspended its plenary rules to allow Health Secretary Ted Herbosa to personally answer the senator’s queries. 

According to Herbosa, the Zero Balance Billing applies only to DOH-retained hospitals for all patients in basic wards. 

On the other hand, the NBB applies only to indigents and only within the PhilHealth case rate limits – a fixed amount the health insurance agency pays directly to the hospital or doctor for a specific illness or procedure – which often do not match actual hospital costs.

Cayetano warned the gap between terminology and reality undermines public trust.

Moreover, the senator also criticized PhilHealth for failing to update its case rates since 2017, making it impossible for NBB to work as advertised.

“The basis of conversation is trust, so if you tell people that it’s ‘no balance' but there is still a balance, why would they name it ‘no balance’ if there is still a balance?” he said.

Despite PhilHealth’s recent implementation of an across-the-board increase for almost all case rate packages to 80%, the senator also said many procedures remain severely unfunded, forcing patients to cover the difference.

“Garbage in is garbage out… we cannot really tell people that we will provide you zero billing (without accurate costing). We cannot promise people then not deliver,” the senator said.

Cayetano urged the government to stop overpromising and underdelivering on healthcare programs.

“We cannot keep announcing programs that confuse the public and fail them in practice. Either i-no balance nila talaga or palitan nila y’ung pangalan,” he said.