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Also, the matters contained in the following were written in accordance with the law, rules, and jurisprudence prevailing at the time of writing and posting, and do not include any future developments on the subject matter under discussion.
AT A GLANCE:
Every Filipino citizen shall be automatically included into the National Health Insurance Program (NHIP). (Section 5, R.A. No. 11223)
Indigenous people shall have the right to special measures for the immediate, effective and continuing improvement of their economic and social conditions, including in the areas of employment, vocational training and retraining, housing, sanitation, health and social security. (Section 25 of R.A. No. 8371)
“Indigenous cultural communities” or “indigenous peoples” (ICCs/IPs) refer to a group of people or homogenous societies identified by self-ascription and ascription by others, who have continuously lived as organized community on communally bounded and defined territory, and who have, under claims of ownership since time immemorial, occupied, possessed and utilized such territories, sharing common bonds of language, customs, traditions and other distinctive cultural traits, or who have, through resistance to political, social and cultural inroads of colonization, non-indigenous religions and cultures, became historically differentiated from the majority of Filipinos.
The term “Indigenous peoples” or “indigenous cultural communities” include peoples who are regarded as indigenous on account of their descent from the populations which inhabited the country, at the time of conquest or colonization, or at the time of inroads of non-indigenous religions and cultures, or the establishment of present state boundaries, who retain some or all of their own social, economic, cultural and political institutions, but who may have been displaced from their traditional domains or who may have resettled outside their ancestral domains. (Section 3, par. h, Republic Act No. 8371 or the Indigenous Peoples’ Rights Act)
Under the Indigenous Peoples’ Rights Act (Republic Act No. 8371), the State recognizes its obligations to respond to the strong expression of the ICCs/IPs for cultural integrity by assuring their maximum participation in the direction of education, health, as well as other services of ICCs/IPs, in order to render such services more responsive to the needs and desires of these communities. (Section 2, par. f, R.A. No. 8371)
Section 25 of R.A. No. 8371 provides that:
“The ICCs/IPs have the right to special measures for the immediate, effective and continuing improvement of their economic and social conditions, including in the areas of employment, vocational training and retraining, housing, sanitation, health and social security.”
Meanwhile, under the Universal Health Care Act (Republic Act No. 11223) it is a declared policy of the State to protect and promote the right to health of all Filipinos and instill health consciousness among them. (Section 2, R.A. No. 11223)
The law says:
“Towards this end, the State shall adopt:
(a) An integrated and comprehensive approach to ensure that all Filipinos are health literate, provided with healthy living conditions, and protected from hazards and risks that could affect their health;
(b) A health care model that provides all Filipinos access to a comprehensive set of quality and cost-effective, promotive, preventive, curative, rehabilitative and palliative health services without causing financial hardship, and prioritizes the needs of the population who cannot afford such services;
(c) A framework that fosters a whole-of-system, whole-of-government, and whole-of-society approach in the development, implementation, monitoring, and evaluation of health policies, programs and plans; and
(d) A people-oriented approach for the delivery of health services that is centered on people’s needs and well-being, and cognizant of the differences in culture, values, and beliefs.” (Section 2, R.A. No. 11223)
The Universal Health Care Act provides that all Filipinos are included in the National Health Insurance Program (NHIP) and shall enjoy the benefits under the program.
The law says:
“Every Filipino citizen shall be automatically included into the NHIP, hereinafter referred to as the Program.” (Section 5, R.A. No. 11223)
Membership in the NHIP is classified into two (2) types: direct and indirect contributors. (Section 8, R.A. No. 11223)
Direct contributors refer to those who have the capacity to pay premiums, are gainfully employed and are bound by an employer-employee relationship, or are self-earning, professional practitioners, migrant workers, including their qualified dependents, and lifetime members. (Section 4, par. f, R.A. No. 11223)
Indirect contributors refer to all others not included as direct contributors, as well as their qualified dependents, whose premium shall be subsidized by the national government including those who are subsidized as a result of special laws. (Section 4, par. o, R.A. No. 11223)
Based on the foregoing, indigent people belong to the latter classification with respect to coverage with the National health Insurance Program.
Indirect contributors shall not be charged any premium contributions. Instead, premium subsidy for indirect contributors shall be adjusted and included annually in the General Appropriations Act and released to PhilHealth.
It must be noted that for every increase in the rate of contribution of direct contributors and premium subsidy of indirect contributors, PhilHealth shall provide for a corresponding increase in benefits.
The law says:
“Section 9. Entitlement to Benefits. – Every member shall be granted immediate eligibility for health benefit package under the Program: Provided, That PhilHealth Identification Card shall not be required in the availment of any health service: Provided, further, That no co-payment shall be charged for services rendered in basic or ward accommodation: Provided, furthermore, That co-payments and co-insurance for amenities in public hospitals shall be regulated by the DOH and PhilHealth: Provided, finally, That the current PhilHealth package for members shall not be reduced.
PhilHealth shall provide additional Program benefits for direct contributors, where applicable: Provided, That failure to pay premiums shall not prevent the enjoyment of any Program benefits: Provided, further, That employers and self-employed direct contributors shall be required to pay all missed contributions with an interest, compounded monthly, of at least three percent (3%) for employers and not exceeding one and one-half percent (1.5%) for self-earning, professional practitioners, and migrant workers.
Section 10. Premium Contributions. – For direct contributors, premium rates shall be in accordance with the following schedule, and monthly income floor and ceiling:
|
Year |
Premium Rate |
Income Floor |
Income Ceiling |
|
2019 |
2.75% |
P10,000.00 |
P50,000.00 |
|
2020 |
3.00% |
P10,000.00 |
P60,000.00 |
|
2021 |
3.50% |
P10,000.00 |
P70,000.00 |
|
2022 |
4.00% |
P10,000.00 |
P80,000.00 |
|
2023 |
4.50% |
P10,000.00 |
P90,000.00 |
|
2024 |
5.00% |
P10,000.00 |
P100,000.00 |
|
2025 |
5.00% |
P10,000.00 |
P100,000.00 |
Provided, That for indirect contributors, premium subsidy shall be gradually adjusted and included annually in the General Appropriations Act (GAA): Provided, further, That the funds shall be released to PhilHealth: Provided, furthermore; That the DOH, in coordination with PhilHealth, may request Congress to appropriate supplemental funding to meet targeted milestones of this Act: Provided, finally, That for every increase in the rate of contribution of direct contributors and premium subsidy of indirect contributors, PhilHealth shall provide for a corresponding increase in benefits.” (Section 9 and 10, R.A. No. 11223)
Read also: Imprisonment for non-remittance of SSS, Pag-IBIG and PhilHealth contributions
Alburo Alburo and Associates Law Offices specializes in business law and labor law consulting. For inquiries regarding taxation and taxpayer’s remedies, you may reach us at info@alburolaw.com, or dial us at (02)7745-4391/0917-5772207.
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