Republic of the Philippines
HOUSE OF REPRESENTATIVES
Quezon City, Metro Manita\

FIFTEENTH CONGRESS
First Regular Session

House Bill No.__ 4150

Introduced by Representative Feliciano Belmonte; Jr. and
Representative Neptali M. Gonzales II

EXPLANATORY NOTE

It is the policy of the State to “adopt an integrated and comprehensive approach
to health development which shall endeavour to make essential goods, health and other
social services available to all people at affordable costs". R.A. 7875, otherwise known
as the “National Health Insurance Act of 1995", mandates that an affordable and
accessible health care coverage should be made available to all citizens. However
access to health care remains to be a problem, most specially to the poor segments of
the population

This bill aims to provide a definite targeting strategy in identifying the poor and
thus, hasten the process of identifying the indigent Filipinos through the use of a means
test set by the national government. In doing so, this will allow the national government
to effectively use funds to provide health insurance coverage for the said group. Finally,
the bill seeks to establish a roadmap towards universal health care through a refocused
and strengthened PhilHealth.

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

Da ae

FELICIANO BELMONTE, JR.

NEPTALI M. GONZALES II


FIFTEENTH CONGRESS OF THE)
REPUBLIC OF THE PHILIPPINES —)

First Regular Session )
HOUSE OF REPRESENTATIVES
HB.No.__4150

Introduced by Representative Feliciano R. Belmonte, Jr. and
Representative Neptali M. Gonzales I

AN ACT PROVIDING A DEFINITE TARGETING STRATEGY IN IDENTIFYING THE
POOR, AMENDING 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 House of Representatives and Senate in Congress of the
Philippines assembled:

SECTION 1. Sec. 4, Article Il of Republic Act No. 7875, is hereby further
amended by adding the following definitions accordingly.

"SEC. 4. Definition of Terms. — For the purpose of this Act, the following terms
shall be defined as follows:

Q) Indigent — A person who has no visible means of income, or whose income is
insufficient for the subsistence of his family based on specific criteria set by the
Department of Health in accordance with the guiding principles set forth in Article | of
this Act.

mm) INFORMAL SECTOR — REFERS TO THAT SECTOR CONSISTING OF
ECONOMIC UNITS ENGAGED IN THE PRODUCTION OF GOODS AND SERVICES.
WITH THE PRIMARY OBJECTIVE OF GENERATING EMPLOYMENT AND INCOMES
TO THE PERSONS CONCERNED IN ORDER TO EARN A LIVING, INCLUDING
HOUSEHOLD UNINCORPORATED ENTERPRISES THAT ARE MARKET AND NON-
MARKET PRODUCERS OF GOODS AS WELL AS MARKET PRODUCERS OF
SERVICES. TO THIS SECTOR BELONG, AMONG OTHERS, STREET HAWKERS,
MARKET VENDORS, PEDICAB AND TRICYCLE DRIVERS, SMALL CONSTRUCTION
‘WORKERS AND HOME-BASED INDUSTRIES AND SERVICES.

SEC. 2. Section 16 of the same act is hereby further amended to read as
follows:

“Sec. 16. Powers and Functions. - The Corporation shall have the following
powers and functions:

() TO VISIT, ENTER AND INSPECT FACILITIES OF HEALTH CARE
PROVIDERS AND EMPLOYERS AND TO SECURE COPIES OF THEIR MEDICAL
AND FINANCIAL RECORDS AS WELL AS THAT OF THEIR PATIENTS OR
EMPLOYEES, WHERE APPLICABLE, WHO ARE BENEFICIARIES OR MEMBERS OF
THE PROGRAM.


(s)_TO ENTER INTO AGREEMENTS WITH NATIONAL AGENCIES AND
LOCAL GOVERNMENTS TO REQUIRE PROOF OF PHILHEALTH MEMBERSHIP
BEFORE TRANSACTING WITH PRIVATE INDIVIDUALS OR GROUPS.

‘SEC.3. Section 18 of the same Act, is hereby amended to read as follows:

Sec. 18. The Board of Directors. (a) Composition — The Corporation shall be governed by a
Board of Directors hereinafter referred to as the Board, composed of the following members:

9 The Secretary of Health;

11 The Secretary of Labor and Employment or his representative;

The Secretary of the Interior and Local Government or his Representative;

iS The Secretary of Social Welfare and Development or his Representative;

17 The President ofthe Corporation;

DOA representative of the labor sector;

HA representative of employers;

23 The SSS Administrator o his representative;

25 The GSIS General Manager or his representative;

27 The Vie chairperson for the basic sector of the National Anti-Poverty Commission or his
28 representative;

29
30 A representative of Filipino overseas workers;

31

32 A representative of the self-employed sector; and
33

34 A representative of health care providers to be endorsed by the national associations of

35 _ health care institutions and medical health professionals.

36

37 A REPRESENTATIVE OF THE LEAGUE OF PROVINCES OF THE PHILIPPINES

38

39 AREPRESENTATIVE OF THE UNION OF LOCAL AUTHORITIES OF THE PHILIPPINES.
40

41 The Secretary of Health shall be the ex officio Chairperson while the President of the

42 Corporation shall be the Vice Chairperson of the Board.

43

4a

45 SEC. 4. Section 28 of the same Act, is hereby amended as follows:

46

47 “Sec. 28 Contributions. — All enrolled members who can afford to pay’shall
48 contribute to the Fund, in accordance with a reasonable, equitable and
49 progressive contribution schedule.

50

51 b) CONTRIBUTIONS FROM THE INFORMAL SECTOR SHALL BE BASED

52 PRIMARILY ON HOUSEHOLD EARNINGS AND ASSETS.
53

54 ‘SEC. 5 . Section 29 of the same Act is hereby amended to read as follows:


“SEC. 29. Payment for Indigent Contributions. - CONTRIBUTIONS FOR’THE PHILIPPINE
POPULATION BELONGING TO THE POOREST 20% OF THE POPULATION AS.
IDENTIFIED BY A MEANS TEST DETERMINED BY THE DEPARTMENT OF HEALTH
SHALL BE SUBSIDIZED ENTIRELY BY THE NATIONAL GOVERNMENT. ALLOCATION
FOR THE ENROLLMENT OF THESE INDIGENTS SHALL BE APPROPRIATED IN THE
GENERAL APPROPRIATIONS ACT AS A SEPARATE LINE ITEM IN THE DEPARTMENT
OF HEALTH BUDGET AND INCREASED ANNUALLY TO COVER FOR PROPORTIONATE
INCREASE IN THE NUMBER OF THE POOR BASED ON THE POPULATION GROWTH
RATE. THE NEXT POOREST 20% OF THE POPULATION OR THE POOR AS IDENTIFIED
BY THE SAME MEANS TEST SHALL BE SUBSIDIZED ENTIRELY BY THE LOCAL
GOVERNMENT UNITS OR BY COST SHARING MECHANISMS BETWEEN THE LOCAL
GOVERNMENT AND THE PRIVATE SECTOR.

SEC. 6. Implementing Rules & Regulations - The Department of Health (DOH) and
the Philippine Health Insurance Corporation (PhilHealth) shalll issue the necessary rules and
regulations to implement the provisions of this Act.

SEC. 7. Repealing Clause - All laws, issuances or any part thereof inconsistent with
this Act are hereby repealed or modified accordingly.

SEC. 8. Effectivity. - This Act shall take effect fifteen (15) days after its complete
publication in the Official Gazette or in at least two (2) national newspapers of general
circulation.

Approved,