New NHIF rules draw anger from MPs, Cotu

Standard Team

Laikipia Governor Ndiritu Muriithi chats with a mother at Nyahururu County Referral Hospital yesterday. Mr Muriithi is one of the leaders unhappy with new NHIF rules. [James Munyeki, Standard]

New regulations from the State health insurer have been met by protests.

 The workers’ union, and a number of MPs and governors have voiced their displeasure with the
National Hospital Insurance Fund’s (NHIF) rules, which have been described as “punitive”. Yesterday, the Central Organisation of Trade Unions (Cotu), through its deputy secretary general Benson Okwara, demanded that the regulations be reversed “These rules are punitive and retrogressive. They are being pushed by individuals who want to frustrate operations at NHIF,” said Mr Okwaro at a press briefing in Nairobi.

Not consulted

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Cotu has a representative on the NHIF board, but Okwaro said the union was not consulted when the laws were formulated. He further alleged that the new changes were a result of mismanagement at the fund. One of the new regulations from NHIF requires individuals who voluntarily join the scheme to wait for three months before accessing scheme benefits. They will also be required to pay a year’s contribution, which is Sh6,000, in advance within the three months. 

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Okwaro said the regulations would deny people in the informal sector access to medical care. “Some people in the informal sector are paid Sh500. These people can’t pay the amount demanded by NHIF within three months,” he said. SEE ALSO :Reforms will make NHIF efficient and sustainable
He added that Cotu has written to NHIF Chief Executive Nicodemus Odongo, asking for an urgent meeting to discuss the matter. Mr Odongo, however, has defended the new rules, saying they would ensure the sustainability of the fund by cushioning it from overutilisation by individuals. Cotu’s sentiments have been shared by a number of parliamentarians. Gilgil MP Martha Wangari said the new rules would add to the misery being experienced by ordinary Kenyans. Ms Wangari joins Murang’a Woman Rep Sabina Chege and Kiambu MP Jude Njomo in rejecting the new regulations. The MPs said the rules are illegal since Parliament has not approved them. “You cannot tell Kenyans to pay upfront yet the same cover will start helping them after three months. This is illegal,” said Ms Chege. Wangari said NHIF should have consulted widely before coming up with the regulations, adding that Kenyans were struggling under a harsh economic climate, and did not need any more punitive measures piled onto them. She said the Constitution was clear on the procedure that should be followed before such rules are introduced.  “There was no public participation. No one was consulted. This is a blatant violation of legal instruments,” she said. Wangari added that NHIF was a public body and its decisions needed to be approved by Parliament. Former Naivasha MP John Mututho urged President Uhuru Kenyatta to disband the NHIF board since it was a threat to his universal health coverage (UHC) agenda. “NHIF needs a radical surgery to weed out cartels who have been running it down,” he said. “The board and NHIF management should be fired for these rules. President Uhuru Kenyatta should do to NHIF what he did to managers at Kenya Ferry Services.” Mr Mututho continued: “This is a major policy decision that needed the involvement of the Parliamentary Committee on Health. The committee was not involved, yet the new rules took effect on January 1.” Kajiado Governor Joseph ole Lenku warned that the proposals would undermine efforts to ensure UHC. “We know the changes were proposed with the intention of improving services. But we should plan better to avoid disrupting the medical scheme,” said Mr Lenku. He noted that access to healthcare in counties like Kajiado is difficult. The new rules, according to other leaders who were interviewed, are likely to slow down the uptake of the NHIF scheme.

Undermine UHC

Already NHIF has started enforcing the regulations. Laikipia Governor Ndiritu Muriithi, however, warned that this may scare away new contributors and undermine efforts by county governments to realise UHC. The governor further termed the recommendation that new members pay the full amount of Sh6,000 before accessing services “outrageous”. “Kenyans have been willing to pay for NHIF services but these restrictions will make them suffer even more,” said Mr Muriithi. “How do you expect people who are already poor to afford Sh6,000 before they access services? They should be allowed to pay in instalments.” He added that the NHIF board was using an outdated model to price its services. Further, under the new regulations, women can only access maternity cover six months after joining the scheme. [Wainaina Wambu, Peterson Githaiga, Antony Gitonga, Kennedy Gachuhi and James Munyeki]