PhilHealth: Benefits plan won't be affected should Marcos suspend premium hike

The Philippine Health Insurance Corporation's (PhilHealth) plan to expand the coverage of its benefits packages this year will still push through even if President Ferdinand "Bongbong" Marcos Jr. suspends the mandated increase in premium rates as scheduled under the Universal Health Care (UHC) law.

At a press conference in Pasig City on Friday, PhilHealth president and CEO Emmanuel Ledesma Jr. said that the state health insurer already implemented the increase in premium or contribution rate this year in the absence of any directive from the President to suspend.

"There is no message or directive from Malacañang so we already [implemented] the increase," Ledesma said.

To recall, Marcos ordered the suspension of the premium rate and income ceiling hike of PhilHealth for the calendar year 2023, citing the socioeconomic challenges caused by the pandemic.

Last year, the premium rate was supposed to increase to 4.5%, while the monthly basic salary ceiling should have been P90,000.

For this year, the premium rate will go up to 5% while the monthly basic salary ceiling will increase to P100,000 and the minimum remains at P10,000.

To illustrate, if a worker earns P10,000 a month, his/her monthly contribution to PhilHealth should amount to P500 effective this year. The premium contribution shall be equally shared between the employee and employer.

Should the President order to suspend anew the scheduled premium hike this year, Ledesma said, "Once we get the directive or instruction, we will immediately comply."

The PhilHealth chief said the state health insurer is expecting an additional P17 billion in revenues this year from the increase in premium rate.

"If PBBM freezes it, that'd be minus P17 billion for the year… but with our current cash position and with all the help we are getting from other agencies, I don't think that anything will be affected, all the plans will push through as expected," Ledesma said.

"We're just talking of minus P17 billion for 2024, I think we will be fine," he said.

This year, Ledesma said the state health insurer is planning to "rationalize six other case rates for the top cases or the most burdensome diseases and commonly availed cases among Filipinos."

"On top of that, PhilHealth is looking into reviewing all case rates in 2024. This is prompted by the increasing costs of healthcare in the country brought about by inflation. This move is expected to greatly lower out-of-pocket expenses of patients during hospitalization and outpatient care," he said.

Ledesma added, "We commit to fund the proposed rationalization and expansion of benefits to ease the burden of the Filipino people in times of medical need and lessen the out-of-pocket expenses of members." — VDV, GMA Integrated News