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Court clears way for new Social Health Insurance Fund

Court clears way for new Social Health Insurance Fund

KENYA— The Court of Appeal has suspended decisions made by the High Court to halt the implementation of the Social Health Insurance Act, 2023.

The Social Health Insurance Act will replace the current National Health Insurance Fund (NHIF) and establish three new funds.

The funds consist of the Primary Healthcare Fund, the Social Health Insurance Fund, and the Emergency, Chronic, and Critical Illness Fund.

The three-judge bench, which included Justices Patrick Kiage, Pauline Nyamweya, and Grace Ngenye, also lifted orders preventing the Primary Health Care Act of 2023 and the Digital Health Act of 2023 from going into effect.

In their decision on Friday, the judges stated that several portions of the Social Health Insurance Act remain suspended pending the hearing and outcome of the appeal.

This contains Section 26(5), which requires registration and contribution before dealing with or using public services from the national and local governments or their corporations.

Section 27(4), which states that a person shall only obtain healthcare services if their contributions to the Social Health Insurance Fund are up to date and active, remains suspended.

While praising the Court of Appeal’s ruling, CS Nakhumicha said that the introduction of the Social Health Insurance Fund (SHIF) set the path for the implementation of Universal Health Coverage.

She stated that this will make healthcare available and inexpensive to all Kenyans, as providing affordable healthcare is a cornerstone of the Kenya Kwanza Government’s Bottom-Up Economic Transformation Agenda.

This opens the way for a robust healthcare system in Kenya, ideally aligning with Universal Health Coverage enrollment strategies. 

According to her, the Social Health Insurance Fund’s principal goal is to create a consolidated pool of all payments made under the Act.

The Act also includes funds for acquiring healthcare services from accredited physicians and institutions, mostly through referrals from primary healthcare practitioners.

It also offers quality healthcare services to Kenyans through accredited healthcare providers at all levels of government hospitals, including Levels 1, 2, 3, 4, 5, and 6.

Furthermore, the Fund’s implementation would prioritize equal access to inexpensive and comprehensive healthcare services for all Kenyans, regardless of their unique diseases.

This patient-centered strategy strives to solve the constraints of the National Health Insurance Fund (NHIF) and provide comprehensive coverage for common illnesses, accidents, chronic ailments, and catastrophic illnesses.

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