FIFTEENTH CONGRESS OF THE 
REPUBLIC OF THE PHILIPPINES 
First Regular Session 
) 
) 
) 
SENATE 
S.B. No. 
2126 
Introduced by Senator Loren Legarda 
EXPLANATORY NOTE 
The State recognizes the vital role of the youth in nation-building and shall 
promote and protect their physical, moral, spiritual, intellectual, and social well-
being. 
Statistics show that a large number of Filipino children are underweight, in 
particular, 31 % of those in pre-school and 33% of those in school-age. Most come 
from families that are living within the poverty belt. Undernutrition paves the way 
for diseases and weaknesses in health, and more often than not, results in lifetime 
disability. 
While the National Health Insurance Act provides a system wherein the poor 
can avail of health services through their membership in the National Health 
Insurance Program (NHIP), there are gaps that need to be filled - particularly on 
children. 
This bill seeks to fill the gaps by increasing the scope and coverage of the 
NHIP to cover the health needs of our children through a Children's Health 
Insurance Program (CHIP). Under this program, eligible children coming from low-
income families shall be entitled to a full range of health services that shall include 
regular check-ups, immunizations, laboratory tests and dental care . 
• 
This proposed legislation is in line with the Millennium Development Goals 
of reducing child mortality, among others. Recognizing the importance of children's 
welfare, especially health-wise, and providing institutional support through such a 
measure, is a step towards fulfilling the goals of providing a world fit for children to 
live in. 
In view of the foregoing, the passage of this bill is earnestly sought. 
~ 
WREN LECARZA 
== 
Senator 


FIFTEENTH CONGRESS OF THE 
REPUBLIC OF THE PHILIPPINES 
First Regular Session 
) 
) 
) 
SENATE 
S.B. No. 
2126 
Introduced by Senator Loren Legarda 
AN ACT 
INSTITUTING MECHANISMS FOR THE ESTABLISHMENT OF A 
• 
CHILDREN'S HEALTH INSURANCE PROGRAM, AMENDING FOR THE 
PURPOSE REPUBLIC ACT NO. 7875, OTHERWISE KNOWN AS 
"THE NATIONAL HEALTH INSURANCE ACT OF 1995," AS AMENDED, 
AND FOR OTHER PURPOSES 
Be it enacted by the Senate and House of the Representatives of the Philippines in 
Congress assembled: 
1 
SECTION 1. Section 4 of Republic Act No. 7875 is hereby amended to read as 
2 
follows: 
3 
"SEC. 4. Definition of Terms. - For the purposes of this Act, the 
4 
following terms shall be defined as follows: 
5 
xxx 
6 
(d) CHILD HEALTH ASSISTANCE - A RANGE OF HEALTH CARE 
7 
AND SUPPORT SERVICES INCLUDING, BUT NOT LIMITED TO, 
8 
PHYSICIAN SERVICES AND ANY OTHER MEDICAL, DIAGNOSTIC, 
9 
SCREENING, PREVENTIVE, RESTORATIVE, REMEDIAL, THERAPEUTIC 
10 
OR REHABILITATIVE SERVICE; 
11 
xxx 
12 
(s) 
Member - Any person whose premiums have been regularly 
13 
paid to the National Health Insurance Program. He may be a paying member, 
14 
an indigent member, A QUALIFIED CHILD MEMBER, or a pensioner / 
15 
retiree member. 
16 
xxx 
17 
(dd) 
QUALIFIED CHILD MEMBER - ANY CHILD OF A LOW-
18 
INCOME F AMIL Y UNDER SIX YEARS OF AGE, OR SIX YEARS OF AGE OR 
19 
OVER BUT IS UNABLE TO FULLY TAKE CARE OF OR PROTECT 
20 
HIMSELF /HERSELF 
FROM 
ABUSE, 
NEGLECT, 
CRVELTY, 
1 


1 
EXPLOITATION OR DISCRIMINATION BECAUSE OF A PHYSICAL, 
2 
MENTAL DISABILITY OR CONDITION, AND WHOSE FAMILY IS BELOW 
3 
POVERTY LINE AS DETERMINED BY THE PERTINENT GOVERNMENT 
4 
AGENCY; 
5 
xxx" 
6 
7 
SECTION 2. Section 5 of the same Act is hereby amended to read as follows: 
8 
"SEC. 5. Establishment and Purpose. - There is hereby created the 
9 
National Health Insurance Program which shall provide health insurance 
10 
coverage and ensure affordable, acceptable, available and accessible health 
11 
care services for all citizens of the Philippines, in accordance with the policies 
12 
and specific provisions of this Act. xxx It shall initially consist of Programs I 
13 
and II of Medicare and be expanded progressively to constitute one universal 
14 
health insurance program for the entire population. IT SHALL INITIATE 
15 
AND EXPAND THE PROVISION OF CHILD HEALTH ASSISTANCE TO 
16 
INCLUDE A CHILD HEALTH INSURANCE PROGRAM FOR UNINSURED, 
17 
LOW-INCOME CHILDREN IN AN EFFECTIVE MANNER THAT IS 
18 
COORDINATED WITH OTHER SOURCES OF HEALTH BENEFITS 
19 
COVERAGE FOR CHILDREN. 
20 
xxx" 
21 
22 
SECTION 3. Section 7 of the same Act is hereby amended to read as follows: 
23 
"SEC. 7. Enrollment. - The Program shall enroll beneficiaries in order 
24 
for them to be placed under coverage that entitles them to avq.il of benefits 
25 
with the assistance of the financial arrangements provided by the Program. 
26 
The process of enrollment shall include the identification of beneficiaries, 
27 
issuance of appropriate documentation specifying eligibility to benefits, and 
28 
indicating how membership was obtained or is being maintained. The 
29 
enrollment shall proceed in accordance with these specific policies: 
30 
a) xxx; 
31 
b) xxx; 
32 
c) xxx; and 
33 
d) xxx. 
34 
All indigents AND QUALIFIED CHILD MEMBERS not enrolled in the 
35 
Program shall have priority in the use and availment of the services and 
2 


1 
facilities of government hospitals, health care personnel, and other health 
2 
organizations: Provided, however, That such government health care 
3 
providers shall ensure that said indigents AND QUALIFIED CHILD 
4 
MEMBERS shall subsequently be enrolled in the Program." 
5 
6 
SECTION 4. Section 12 of the same Act shall now read as follows: 
7 
"SEC 12. Entitlem~nt to Benefits. - xxx 
8 
The following need not pay the monthly contributions to be entitled to 
9 
the Program's benefits: Retirees and pensioners of the SSS and GSIS prior to 
10 
the effectivity of this Act; Members who reach the age of retirement as 
11 
provided for by law and have paid at least one hundred twenty (120) 
12 
monthly contributions; [and] Enrolled indigents; AND (D) QUALIFIED 
13 
CHILD MEMBERS." 
14 
15 
SECTION 5. Section 28 of the same Act is hereby amended to read as follows: 
16 
"SEC 28. Contributions. - All members of the Program shall contribute 
17 
to the Fund, in accordance with a reasonable, equitable and progressive 
18 
contribution schedule to be determined by the Corporation on the basis of 
19 
applicable actuarial studies and in accordance with the following guidelines: 
20 
xxx 
21 
CONTRIBUTIONS MADE IN BEHALF OF A QUALIFIED CHILD 
22 
'MEMBER SHALL NOT EXCEED THE MINIMUM CONTRIBUTIONS SET 
23 
FOR EMPLOYED MEMBERS." 
24 
25 
SECTION 6. A new Section 30 is hereby added to read as follows: 
26 
"SEC 30. PAYMENT FOR A QUALIFIED CHILD MEMBER'S 
27 
CONTRIBUTIONS. 
CONTRIBUTIONS 
FOR 
QUALIFIED 
CHILD 
28 
MEMBERS SHALL BE SUBSIDIZED P ARTIALL Y BY THE LOCAL 
29 
GOVERNMENT 
UNIT 
WHERE 
THE 
MEMBER 
RESIDES. 
THE 
30 
CORPORATION SHALL PROVIDE COUNTERPART FINANCING EQUAL 
31 
TO THE LGU'S SUBSIDY FOR CHILDREN. THE SHARE OF THE LGUS 
32 
SHALL BE PROGRESSIVELY INCREASED UNTIL SUCH TIME THAT 
33 
THEIR SHARE BECOME EQUAL TO THAT OF THE NATIONAL 
34 
GOVERNMENT." 
35 
3 


.' 
,. 
1 
SECTION 7. Implementing Rules and Regulations. - Within thirty (30) days 
2 
from the effectivity of this Act, the Board of Directors of the Philippine Health 
3 
Insurance Corporation (PHIC) shall convene to formulate the rules and regulations 
4 
for the implementation of this Act. 
5 
6 
SECTION 8. Separability Clause. - If any part or provision of this Act shall 
7 
be held unconstitutional or invalid, other provisions which are not affected thereby 
8 
shall continue to be in full force and effect.. 
9 
10 
SECTION 9. Repealing Clause. - All laws, presidential decrees, executive 
11 
orders, rules and regulations or parts thereof which are deemed inconsistent with 
12 
the provisions of this Act are hereby repealed, amended, or modified accordingly. 
13 
14 
SECTION 10. Effectivity Clause. - This Act shall take effect fifteen (15) days 
15 
following its full and complete publication in an Official Gazette or in at least two (2) 
16 
newspapers of general circulation, whichever comes first. 
17 
18 
Approved, 
4