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

NINETEENTH CONGRESS
First Regular Session

House BILL NO, 408

Introduced by Honorable Representatives
ARLENE D. BROSAS (Gabriela Women’s Party),
FRANCE L. CASTRO (ACT Teachers Partylist),
and RAOUL DANNIEL A. MANUEL (Kabataan Partylist)

AN ACT AMENDING REPUBLIC ACT NO. 11223, OTHERWISE KNOWN AS THE
UNIVERSAL HEALTH CARE ACT, REPEALING PROVISIONS ON
COMPULSORY COVERAGE OF MIGRANT WORKERS, MANDATORY PAYMENT
FOR MISSED CONTRIBUTION, AND AUTOMATIC INCREASE OF PREMIUM
CONTRIBUTIONS

EXPLANATORY NOTE

Prior to the enactment of Republic Act 11223 or the Universal Health Care Act in 2019,
PhilHealth members were already entttied to the benefits if they had paid the premium
contributions of at least three months within the six months preceding the availment.
Currently, Section 9 of RA 11223 stated, “failure to pay premiums shall not prevent
the enjoyment of any program benefits,” but itis contrary to what the law enforced that
all missed contributions shall be required to pay with interest.

Since its implementation, the aforementioned provision has burdened members,
employers, and self-employed direct contributors, especially when the COVID-19
pandemic resulted in millions of people losing their jobs because they are required to
pay all missed contributions before a member receives the benefits


Filipinos also faced another problem when Philippine Health Insurance Corp.
(PhilHealth) implemented, beginning in June 2022, the new contribution rate of 4
percent for those with an income floor of P10,000 and income ceiling of P80,000, from
the previous contribution rate of 3 percent. This translates to higher deductions from
the wages and salaries of workers already bearing the brunt of nonstop price hikes.
‘As mandated by Section 10 of Republic Act No. 11223, otherwise known as the
Universal Health Care Act, the premium contributions will be increased by 0.5% every
year from 2021 to 2025. This will effectively increase the current premium rate from
3% of the member's monthly basic salary in 2020 to 3.5% and 5% in 2025

On April 16, 2020, PhilHealth also released Circular 2020-0014, which directs
overseas Filipino workers (OFWs), including land-based and sea-based workers, to.
pay a hefty 3% percent of their income, with premium rate increasing annually by 0.5%
until 2024, as a mandatory premium contribution

Moreover, in 2020, several corruption issues involving PhilHealth were exposed to the
public, including its irregular implementation of the Interim Reimbursement
Mechanism (IRM). According to PhilHealth’s former anti-fraud legal officer Thorrsson
Montes Keith, around P16 billion was corrupted through unauthorized releases of IRM
and proposed overpriced information technology systems. In addition, former
PhilHealth president retired Brig. Gen. Ricardo Morales also previously revealed to
Congress that over P10 billion was lost due to fraud in 2019.

With the current economic situation and unresolved PhilHealth corruption issues, it is
unacceptable, unjust, and insensitive to the Filipino people to be burdened with failure
to access benefits and higher premium contributions.


In view of the foregoing, the approval of this bill is eamestly sought.

~~
NED. BROSAS
Gabriela Women’s Party

RAO#L DANNIEL/A. MANUEL
Kabétaan Partylist



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

NINETEENTH CONGRESS
First Regular Session

House BiLto._*03

Introduced by Honorable Representatives
ARLENE D. BROSAS (Gabriela Women’s Party),
FRANCE L. CASTRO (ACT Teachers Partylist),
and RAOUL DANNIEL A. MANUEL (Kabataan Partylist)

AN ACT AMENDING REPUBLIC ACT NO. 11223, OTHERWISE KNOWN AS THE
UNIVERSAL HEALTH CARE ACT, REPEALING PROVISIONS ON
COMPULSORY COVERAGE OF MIGRANT WORKERS, MANDATORY PAYMENT
FOR MISSED CONTRIBUTION, AND AUTOMATIC INCREASE OF PREMIUM

CONTRIBUTIONS

Be it enacted by the Senate and the House of Representatives of the Philippines in
Congress assembled:

SECTION 1.

SECTION 2.

follows:

Section 4 (f) is hereby amended to read as follows:

2K

(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,
frnigrant-workers}, including their qualified dependents, and lifetime
members;

Section 9 of Republic Act No. 11223 is hereby amended to read as

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 femployers-and-self-employed direct contributors-shall-be
Fequired-to-pay-all-missed-contributions-with-an_interest-compounded
monthly, of atleast three percent{3%) for employers-and not exceeding

ene—and—one-halfpercent—{1.5%)—for-—self-earning—professional
practitioners,-and migrant workers] A MEMBER WITH PAID PREMIUM
CONTRIBUTIONS OF AT LEAST THREE (3) MONTHS WITHIN THE
SIX (6) MONTHS PRIOR TO THE FIRST DAY OF AVAILMENT IS
ENTITLED TO AVAIL OF PROGRAM BENEFITS.

SECTION 3. Section 10 of Republic Act No. 11223 is hereby amended to read as
follows:
Section 10. Premium Contributions —
ffor direct contributors, premium rates shall be in accordance with the
following schedule,and-monthly income floor and-ceiling:
| Ye “Prem nium | Income Floor Income Ceili x)
| Rate | _
[2019] 275% | R40,000 P50,000
|2020 3.00% | P40.000 | _ P60,000
2024) 350% | P4000 |  P70,000
2022, 4.00% | P40,000 | P80,000
2023, 450% | P10,000 | P90.000
{2024 5.00% | P40,000 | P100,000
[2026| 6.00% | P-10,000 | 100,000
—4

FOR DIRECT CONTRIBUTORS, PREMIUM RATES SHALL BE FIXED
AND ADJUSTED FROM TIME TO TIME THROUGH ENACTMENT OF
CONGRESS, TAKING INTO CONSIDERATION ACTUARIAL
CALCULATIONS, RATE OF BENEFITS, AND THE CAPACITY OF
THE MAJORITY OF CONTRIBUTORS TO PAY.

Provided, that for indirect contributors, premium subsidy shall be
gradually adjusted and included annually in the General Appropriations
Act (GAA): Provided, further, that 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 4, Separability Clause. If, for any reason, any portion or provision of this,
Act shall be held unconstitutional or invalid, the remaining provisions not affected
thereby shall continue to be in full force and effect.

SECTION 5. Repealing Clause. All laws, decrees, executive orders and other
presidential issuance, which are inconsistent with this Act, are hereby repealed,
amended or modified accordingly.

SECTION 6. Effectivity. This Act Shall take effect fifteen (15) days after its publication
in the Official Gazette or in at least two (2) newspapers of general circulation

Approved,