KEPSA in partnership with Kenya Healthcare Federation (KHF), hosted a webinar on Social Health Insurance (General Regulations) on 20^th February 2024 aimed at sensitizing members on the potential impact of the bill on businesses encompassing both employers and employees when enacted.

Representing KHF, Dr. Okaka in his presentation outlined recent policy and legislative advancements in the healthcare sector, including an overview of four newly established acts: The Primary Healthcare Act No. 13 of 2023, Facilities Improvement Financing Act No. 14 of 2023, Digital Health Act No. 15 of 2023, and the Social Health Insurance Act No. 16 of 2023. Further, he delved into the provisions of the Social Health Insurance (General Regulations) of 2023, explaining its implementation framework and outlining the roles of government, employers, and employees as per the regulations.

Some of the key highlights were;

• The definition of household to mean a social unit comprising of an eligible contributor, whether contributing by self or paid for, and their beneficiaries, or who share the same social-economic needs associated with consumption and production and the definition of primary healthcare to mean an Essential health care based on practical, scientifically sound and socially acceptable methods and technology, made universally accessible in the community at Levels 1-3 facilities, to meet health needs at every stage, with full participation and at an affordable cost
• The breakdown of funds within the Regulations which include; Primary Healthcare Fund available to all Kenyan residents for primary healthcare services and paid for by government, the Social Health Insurance Fund available to paid up contributors for healthcare services in Level 4-6 facilities and the Emergency, chronic and critical illness fund catered for by the government.  
• The role of employers which is to deduct the respective contributions from employees and maintain up-to-date records of any changes in their employee database.
• The transitional provisions of funds, assets, liabilities and powers present from the NHIF to the SHIF

Some of the major concerns raised were;

• The definition of depletion; whether there is a threshold set for SHIF to be noted as depleted.
• The need for a cap for workers in the formal sector as some are already experiencing the income tax burden
• The method or mechanisms of doctor empanelment and service providers in the healthcare value chain

The meeting concluded with a call to private sector players to provide input on these regulations as public participation is currently ongoing.