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PhilHealth to minimize  premiums, expand coverage, benefits

By J.Lo

“We are fully supporting that reduction…and that is  very huge reduction… I actually made  commitment to sit down with my team in PhilHealth to recommend for  decrease in  premium contributions,” House Assistant Majority Leader Jil Bongalon told  House pane although deprived of subsidy under 2025 approved budget program,  state-run Philippine Health Insurance Corp. (PhilHealth) has assured lawmakers that it would still be able to reduce premium contribution and expand its coverage next year for overall better health care benefits for members.

PhilHealth president and chief executive officer Emmanuel Ledesma Jr. relayed assurance to  Bongalon of party-list Ako Bicol at last week’s hearing by  House committee on good government and public accountability on  national health insurance system.

Ledesma said  intention of PhilHealth leadership to recommend  decrease in contributions, pursuant to  pending Senate measure aiming to reduce  rate from five percent to 3.25 percent.

Ledesma explained nevertheless that premium rates are set by law and that PhilHealth does not unilaterally decide on adjustments.

“All of these are already set…and then just for  information of this honorable body, it’s currently at five percent this year… latest increase,” he said.

At the same time, Ledesma assured lawmakers  PhilHealth remains committed to increasing program benefits. “Our commitment is to increase  program benefits,  hopefully will take effect by next month ,January 2025..”

PhilHealth’s surplus funds,  stand at P150 billion, and reserve funds exceeding P200 billion, remain  key concern for House, led by Speaker Martin Romualdez,  vowed to initiate marathon hearings next year on PhilHealth’s fund management.

The PhilHealth chief  would also be expanding members’ hospitalization coverage by 50 percent, in response to lawmakers’ concerns that  state health insurer must better utilize its substantial reserve funds for  direct benefit of members.

House panel, led by Manila Rep. Joel Chua, stressed  importance of balancing financial sustainability with tangible benefits for PhilHealth members.

Ledesma’s commitment to both reducing contribution rates and expanding health care benefits was welcomed by lawmakers,  vowed to monitor PhilHealth’s progress.

There will be more hearings on PhilHealth issue when Congress resumes session on Jan. 13 next year.

Bongalon stressed that PhilHealth’s mandate includes decreasing contribution rates once reserve funds exceed  ceiling needed to meet expenditures. “That is your mandate…so, can you commit that you will not be focused on benefit expansion alone…can you decrease contribution?”

The Bicolano legislator,  lawyer by profession, also questioned PhilHealth’s allocation of government subsidies, noting that funds intended for indirect contributors appear to have been diverted to investments.

“Same with 2024 General Appropriation Act… budget of PhilHealth was P60 billion, P40 billion  for indirect contributors…so, that is the reason why we could not understand why all of these funds go to investments,” Bongalon said.

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