Republic of the Philippines
HOUSE OF REPRESENTATIVES
Batasan Hills, Quezon City

EIGHTEENTH CONGRESS
First Regular Session

HOUSE BILL No. 8722

Introduced by AKO BICOL Party-List
Rep. ALFREDO A. GARBIN, JR.

EXPLANATORY NOTE

Republic Act No. 11223 or the “Universal Health Care Act” declares the State's
Policy of ensuring that all Filipinos are covered by the Government's Health Care
Insurance Program (HCIP or Philhealth). Section 5 of the law categorically
provides that “every single Filipino citizen shall be automatically included into the
NHIP"”. This is in line with the constitutional mandate to protect and promote the
right to health of all Filipinos?

Evidently, the end goal and be all of the law is to ensure that every Filipino,
employed or unemployed, will have access to the benefits provided by Philhealth.

Indeed, this policy is laudatory as it is necessary. Thus, the aforementioned law
institutionalized the membership of the “indirect contributors” or those whose
premiums are subsidized by the government.

In order to meet the actuarial requirements of the Philhealth, Section 10 of the law
provided a graduated scale for premium payments of direct contributors. Direct
Contributors are 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.*

‘The declared policy and the definition of direct contributors, as currently crafted
by law, however, failed to recognize a very significant distinction between those
who are bound by an employer - employee relationship and those who are self ~
earning professional practitioners, on one hand, and migrant workers/OFWs, on
the other. It failed to recognize that migrant workers/OFWs, who are normally
outside the Philippines, rarely enjoy the benefits of the government's health care

program.

1 National Health Insurance Program
2 Article 2, Par. 15, 1987 Constitution
8 Section 4 (0)

4Section 4 (f)

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Furthermore, under the first classification, for those who are employed, premium
contributions are shared by the employer and the employee on an equal basis. Self-
employed professionals, meanwhile, are able to reap the benefits from their
membership in the health care program because they reside in the Philippines.

On the other hand, however, for the second classification, the entire premium
contribution is shouldered by the migrant workers/OFWs. This is exacerbated by
the aforementioned reality of non-enjoyment of benefits while abroad, more so,
because most of them pays similar insurance premiums in the respective territories
where they are employed or are otherwise residing.

Nonetheless, while Philhealth membership may not be important to the migrant
workers/OFWs at the moment, surely they will benefit once they are residing in
the Philippines or have already retired.

Fairly recently, the Philhealth issued Circular No. 2020-0014 dated 2 April 2020
which increased the premium payments of OFWs whose monthly income ranged
from P10,000.00 to P60,000.00 of their monthly salary starting this year. The
circular also states that from 1 January 2021, the minimum acceptable initial
payment is a three-month premium, based on the prescribed rate at the time of
payment.

The subsequent publication of the Philhealth Circular was met with a steady
uproar and opposition from the OFWs and even from other government officials.
This was to be expected considering the financial burden it imposes and in
consideration of the reality that few migrant workers/OFWs actually benefit from
Philhealth coverage while abroad.

As a remedial measure, the government announced that: a) Philhealth
membership will become voluntary for OFWs; b) Suspension of the provision of
the universal Health Care Act which authorizes the increase in premium
payments; and c) Directive that Philhealth payment will not be a requirement for
issuance of Overseas Employment Certificate.

It is respectfully submitted, however, that the foregoing measures are not enough
and may in fact be ultra vires because it contravene some provisions of the
Universal Health Care Act.

Thus, as an alternative, and as a legislative correction to the unintended inequality
resulting from the Universal Health Care Act, and to ensure that all Filipinos, who
desires to be covered by the health program, are covered, it is respectfully
proposed that the same be amended by institutionalizing, by way of legislative
fiat, the remedial measures earlier proposed by the government.

The approval ill is earnestly sought.

Rep. Alfredo Aj Garbin, Jr.
Ako Bicol Party-List

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6722

AN ACT AMENDING REPUBLICT ACT NO. 11223 OTHERWISE KNOWN

AS THE “UNIVERSAL HEALTH CARE ACT”

Be it enacted in the Senate and the House of Representatives in Congress

assembled:

Section 1. Section 4 of Republic Act No. 11223 is hereby amended to read

as follows:

“Section 4. Definition of Terms. - As used in this
Act:

Xxx,

(f) 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;

Xxx,

workers or Overseas Filipino Workers (OFWs);

{e}(p) 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;

(p) (q) Individual-based health services refer to
services which can be accessed within a health
facility or remotely that can be definitively traced
back to one (1) recipient, has limited effect at a
population level and does not alter the
underlying cause of illness such as ambulatory
and inpatient care, medicines, laboratory tests
and procedures, among others;

(4) (0) Population-based health services refer to
interventions such as health promotion, disease
surveillance, and vector control, which have
population groups as recipients;

() (8) Primary care refers to initial-contact,
accessible, continuous, comprehensive and
coordinated care that is accessible at the time of

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need including a range of services for all
presenting conditions, and the ability to
coordinate referrals to other health care providers
in the health care delivery system, when
necessary;

(6) (t) Primary care provider refers to a health care
worker, with defined competencies, who has
received certification in primary care as
determined by the Department of Health (DOH)
or any health institution that is licensed and
certified by the DOH;

48 (u) Private health insurance refers to coverage
of a defined set of health services financed
through private payments in the form of a
premium to the insurer; and

(8) (v) Unethical act refers to any action, scheme
or ploy against the NHIP, such as overbilling,
upcasing, harboring ghost patients or recruitment
practice, or any act contrary to the Code of Ethics
of the responsible persons profession or practice,
or other similar, analogous acts that put or tend to
put in disrepute the integrity and effective
implementation of the NHIP.”

Section 2. Section 5 of Republic Act No. 11223 is hereby amended to read

as follows:

“Section 5. Population Coverage. - Every Filipino
citizen, except those who are classified as offshore
contributors, shall be automatically included into
the NHIP, hereinafter referred to as the Program,
Offshore contributors shall become members on a
voluntary basis pursuant to the provisions of

existing laws, rules and regulations.’

Section 3. Section 10 of Republic Act No. 11223 is hereby amended to read

as follows:

“SEC. 10. Premium Contributions. - For direct
contributors, premium rates shall be in
accordance with the following schedule, and
monthly income floor and ceiling:

Xxx

Provided that, the premium contributions for
offshore contributors shall be fifty percent (50%)
of the applicable premium rates. The fifty percent

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(50%) balance shall be for the account of and shall
be similarly subsidized by the government.

Provided further, that for indirect contributors
and offshore contributors, premium subsidy shall
be gradually adjusted and included annually in
the General Appropriations Act (GAA): Xxx”

Section 4. Section 38 of Republic Act No. 11223 is hereby amended to read

as follows:

“Section 38. Penal Provisions.- Any violation of
the provisions of this Act, after due notice and
hearing, shall suffer the corresponding penalties
as herein provided:

Xxx,

(It is unlawful for any government office,
agency _or_official_to deprive _an_offshore
contributor of any and all permits to work abroad
on the basis of failure to pay or remit premium
contribution to the Philhealth.

Xxx”

Section 5. The provisions in pertinent laws and implementing rules and
regulations and other issuances inconsistent with this Act are hereby repealed or
modified accordingly.

Section 6. This Act shall take effect fifteen (15) days following its
publication in at least two (2) newspapers of general circulation.

Approved,

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