TWENTIETH CONGRESS OF THE 
REPUBLIC OF THE PHILIPPINES 
First Regular Session
)
SENATE 
S. No.__ 3
25 JUL-2 P4 -08
INTRODUCED BY SENATOR JV EJERCITO
AN ACT
AMENDING REPUBLIC ACT NO. 11223, OTHERWISE KNOWN AS THE 
"UNIVERSAL HEALTH CARE AO-
EXPLANATORY NOTE
The Universal Health Care Act (UHC) is the embodiment of government care. 
It was a bill crafted and passed into law for its effects to be beneficiai and directly felt 
by all Filipinos. However, more than a piece of legislation, the UHC was meant to serve 
as a guiding iight for our government in times of heaith care crises and emergencies; 
but perhaps most importantly, a relief for our less fortunate country men in dire need 
of medical attention.
Every single day, our people who struggle to make ends meet, are given a 
tough choice between undergoing treatment or focusing on survival. The high cost of 
medicai care instantly drives away a patient from seeking not oniy hospitalization but 
a mere basic medical checkup.
Even though it is already more or less five years since the COVID-19 pandemic 
ravaged our people's lives physically and economically, the truth of the matter is that 
we are still in the period of recovery. Soaring inflation and war in the Middle East have 
affected the rise of fuel prices and consequently, basic commodities. Ali of which have 
very much contributed to the economic hardships of families making our peopie care 
less about their heaith and wellbeing.


This bill aims to lighten the financial burden of every Filipino by amending the 
UHC Act to further address their current health needs. The PhilHealth premium 
contribution shall be lowered to a more reasonable amount while ensuring that more 
health benefit packages shall be formulated, developed; and existing packages 
improved. In lowering premiums, we uplift the lives of our people.
Recently, outrage sparked when Philippine Health Insurance Corporation 
(Philhealth) was ordered to return to the Bureau of Treasury an alleged excess funds. 
This happened despite the provision in the UHC that no portion of the reserve fund 
shall accrue to the general fund of the National Government. In order to ensure that 
this will not be repeated, the proposed bill requires the Department of Health and 
Philhealth to establish a mechanism for lowering premium contributions. The 
mechanism will be used whenever there is an excess of the Philhealth reserve funds 
that will not be used to increase benefit packages.
Lastly, the proposed bill mandates the Philhealth Board to submit annual audit 
reports and a fund viability plan to Congress. It further requires Philhealth to engage 
an independent, reputable, and accredited third-party auditor to review Philhealth's 
actuarial projections. The objective is for Philhealth to improve public confidence 
through strengthened audit mechanisms and actuarial transparency.
To reiterate, the proposed amendments in this measure aims to further our 
goals of having a healthy nation. We stand firm of our vision: Filipinos taking care of 
fellow Filipinos. It is then with a deeper sense of duty that we refile this measure in 
the Twentieth Congress.
In view of the foregoing, the passage of this measure is earnestly sought.
JV EJERCITO


TWENTIETH CONGRESS OF THE 
REPUBLIC OF THE PHILIPPINES 
First Regular Session
)
SENATE 
S. No.____3
25 JUL -2 P4 :08
INTRODUCED BY SENATOR JV EJERCITO
AN ACT
AMENDING REPUBLIC ACT NO. 11223f OTHERWISE KNOWN AS THE 
"UNIVERSAL HEALTH CARE ACT"
Be it enacted by the Senate and the House of Representatives of the Philippines, in 
Congress assembled:
1 
Section 1. Section 9 of Republic Act No. 11223 is hereby amended to read as
2 
follows:
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Sec. 9. Entitlement to Benefits. - Every member shall be granted
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immediate eligibility for health benefit package under the NHIP: Provided,
5 
That PhilHealth Identification Card shall not be required in the availment
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of any health services: Provided further. That no co-payments shall be
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charged for services rendered in basic accommodation: Provided
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furthermore. That co-payments and co-insurance for amenities in public
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hospitals shall be regulated by the DOH and PhilHealth: PROVIDED,
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FURTHERMORE, THAT THE PHILHEALTH BOARD, IN
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CONSULTATION WITH THE HEALTH TECHNOLOGY ASSESSMENT
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COUNCIL, SHALL CONDUCT PERIODIC REVIEW AND AJUSTMENT
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OF BENEFIT PACKAGES EVERY THREE YEARS AFTER THE
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EFFECTIVITY OF THIS ACT: Provided, finally. That the current
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PhilHealth package for members shall not be reduced.


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PhilHealth shall provide additional NHIP benefits for direct
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contributors, where applicable: Provided, That failure to pay premiums shall
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not prevent the enjoyment of any NHIP benefits: Provided further, That
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employers [and self-employed direct contributors] shall be required to pay
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all missed contributions with an interest, compounded monthly, of at least
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three percent (3%) for employers [and not exceeding 1.5% for self-earning,
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professional practitioners, and migrant workers].
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Sec. 2. Section 10 of Republic Act No. 11223 is hereby amended to read as
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follows:
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SEC. 10. Premium Contributions. - For direct contributors,
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premium rates shall be in accordance with the following schedule, and
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monthly income floor and ceiling:
-rear
2049
2020
2024
2022
2023
2024
2025
Premium
Rate
2t25%
3t00%
3t50%
4t00%
4t50%
5.00%
5.00%
Income Floor
P10,000.00
P1O,0OO.OO
P10,000.00
P10,000.00
P10,000.00
P10,000.00
P10,000.00
Income Coiling
P50,000.00
P60,000.00
P70,000.00
P80,000.00
P90,000.00
P100,000.00
PlOO,OO0.00j
YEAR
PREMIUM
INCOME
INCOME
RATE
FLOOR
CEILING
2026 - 2028
3.5%
P10,000.00
P100,000.00
2029 - 2031
4.5%
P10,000.00
P100,000.00
2032 - 2035
5%
P10,000.00
PlOO,000.00
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15
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FOR MIGRANT WORKERS, PREMIUM CONTRIBUTIONS 
SHALL BE BASED ON THE INCOME FLOOR: PROVIDED, THAT 
FIFTY PERCENT (50%) OF THE PREMIUM CONTRIBUTION OF 
MIGRANT WORKERS SHALL BE SHOULDERED BY THE NATIONAL


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GOVERNMENT : PROVIDED FURTHER, THAT EMPLOYERS OF 
SEAFARERS, THROUGH THE LOCAL MANNING AGENCIES, SHALL 
CONTINUE TO SHOULDER FIFTY PERCENT (50%) OF THE 
PREMIUM CONTRIBUTION OF THE SEADARERS: PROVIDED 
FURTHERMORE, THAT UNPAID PREMIUM CONTRIBUTIONS OF 
MIGRANT WORKERS IN DISTRESS UNDER REPUBLIC ACT NO. 
8042, OR THE 'MIGRANT WORKERS AND OVERSEAS FILIPINOS 
ACT OF 1995', AS AMENDED BY REPUBLIC ACT NO. 10022 SHALL 
NOT BE COLLECTED UPON THEIR ARRIVAL IN THE COUNTRY: 
PROVIDED FINALLY, THAT FAILURE TO PAY PHILHEALTH 
CONTRIBUTION SHALL NOT BE A GROUND FOR NON-ISSUANCE 
OF OVERSEAS EMPLOYMENT CERTIFICATE OF A MIGRANT 
WORKER.
[Provided, That f]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 furthei[-mere\: That the DOH, in 
coordination with Philhealth, may request Congress to appropriate 
supplemental funding to meet targeted milestones of this Act: Provided 
finaiiy. 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.
IN THE EVENT OF A STATE OF NATIONAL EMERGENCY, 
PUBLIC HEALTH EMERGENCY, OR STATE OF CALAMITY, THE 
PRESIDENT OF THE PHILIPPINES, UPON RECOMMENDATION 
OF THE PHILHEALTH BOARD AFTER CONSULTATION WITH 
STAKEHOLDERS, MAY SUSPEND THE INCREASE IN PREMIUM 
CONTRIBUTION RATES PROVIDED UNDER THIS SECTION. THE 
MANDATED INCREASE SHALL BE IMPLEMENTED UPON LIFTING 
OF THE STATE OF NATIONAL EMERGENCY, PUBLIC HEALTH 
EMERGENCY, OR STATE OF CALAMITY. IN THE EVENT OF 
SUSPENSION, ALL SUBSEQUENT SCHEDULED INCREASES IN


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CONTRIBUTION RATES SHALL BE IMPLEMENTED IN THE
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SUCCEEDING YEARS ACCORDINGLY.
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Sec 3. Section 11 of Republic Act 11223 is hereby amended to read as follows:
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Sec 11. Program Reserve Funds - Philhealth shall set aside a
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portion of its accumulated revenues AS MENTIONED IN SECTION 37
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OF THIS ACT AND ANY OTHER INCOME FROM ANY SOURCE not
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needed to meet the cost of the current year's expenditures as reserve
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funds: Provided, That the total amount of reserves shall not exceed a
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ceiling equivalent to the amount actuarially estimated for two (2) years'
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projected Program expenditures: Provided, further. That whenever
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actual reserves exceed the required ceiling at the end of the fiscal year,
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the excess of the Philhealth reserve fund shall be used to increase the
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Program's benefits and to the decrease the [amount of-niefBbeFs'
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contributions] PREMIUM CONTRIBUTION RATES OF MEMBERS:
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PROVIDED, FINALLY, THAT THE DOH AND PHILHEALTH SHALL
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INCLUDE A MECHANISM FOR 
LOWERING PREMIUM
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CONTRIBUTION RATES IN THE IMPLEMENTING RULES AND
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REGULATIONS OF THIS ACT.
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Sec 4. Republic Act 11223 is hereby amended by inserting a new section to
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read as follows:
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"SEC. 37-A. SUBMISSION OF AUDIT REPORT AND FUND
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VIABILITY PLAN. - THE PHILHEALTH SHALL SUBMIT THE
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FOLLOWING REPORTS ANNUALLY TO THE DBM, THE SENATE,
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AND THE HOUSE OF REPRESENTATIVES:
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(A) MANAGEMENT AUDIT 
REPORT DETAILING
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POLICIES AND REFORMS TO CONTROL FRAUDULENT
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PRACTICES; AND
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(B) FUND VIABILITY PLAN, INCLUDING POLICIES AND
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REFORMS TO STRENGTHEN PREMIUM COLLECTION,
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INCREASE PROGRAM BENEFITS, AND MINIMIZE THE
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RISK OF DEFICITS."


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Sec 5. Republic Act 11223 is hereby amended by inserting a new section to
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read as follows:
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"SEC. 37-B. THIRD-PARTY AUDITOR. - THE PHILHEALTH
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SHALL ENGAGE A THIRD-PARTY AUDITOR TO REVIEWITS
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ACTUARIAL PROJECTIONS AND BENEFIT PACKAGES ANNUALLY
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TO ENSURE THE EFFECTIVE IMPLEMENTATION OF ITS
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MANDATE: PROVIDED, THAT THE THIRD-PARTY AUDITOR SHALL
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BE INDEPENDENT, REPUTABLE, AND DULY ACCREDITED AS
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SUCH BY AN ACCREDITING OR SIMILAR AGENCY RECOGNIZED
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BY INDUSTRY EXPERTS: PROVIDED, FURTHER, THAT NOTHING
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HEREIN SHALL PREVENT THE BUREAU OF INTERNAL REVENUE
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AND THE COMMISSION ON AUDIT FROM UNDERTAKING A POST-
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AUDIT INDEPENDENT VERIFICATION OF THE GROSS REVENUE
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OF PHILHEALTH AS DETERMINED BY THE THIRD-PARTY
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AUDITOR."
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Sec 6. Continuity of Benefits - Nothing in this Act shall be construed to eliminate
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or diminish any benefits or entitlements already granted to members of Philhealth.
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Sec 7. Separability Clause. If any provision of this Act is declared invalid or
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unconstitutional, the remainder thereof not otherwise affected shall remain in full force
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and effect.
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Sec 8. Repealing Clause. - All laws, presidential decrees, executive orders,
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letters of instruction, proclamations, and administrative regulations that are
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inconsistent with the provisions of this Act are hereby repealed, amended or modified
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accordingly.
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Sec 9. Effectivity Clause - This act shall take effect after fifteen (15) days
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following the completion of its publication in the Official Gazette or in any newspaper
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of general circulation.
Approved,