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

TWENTIETH CONGRESS
First Regular Session

HOUSE BILL No. 1973

Introduced by
ACT Teachers Party-List Rep. ANTONIO L. TINIO
and KABATAAN Party-List Rep. RENEE LOUISE M. CO

AN ACT
PROVIDING FOR THE AUTOMATIC APPROPRIATION FOR PUBLIC
HEALTH SERVICES, AMENDING SECTION 31 OF PRESIDENTIAL
DECREE NO. 1177 AND SECTION 26, CHAPTER 4, BOOK VI OF
EXECUTIVE ORDER NO. 292, OTHERWISE KNOWN AS THE
ADMINISTRATIVE CODE OF 1987"

EXPLANATORY NOTE

This Bill mandates the government to allot the equivalent of 5% of gross
domestic product (GDP) for public health services. This will increase the government
budget allotted to people’s health and public health care.

Section 15 Article II of the 1987 Philippine Constitution mandates the State to
“protect and promote the right to health of the people and instill health consciousness
among them.” Section 11 Article XIII further states that “(t)he State shall adopt an
integrated and comprehensive approach to health development which shall endeavor to
make essential goods, health and other social services available to all the people at
affordable cost.”

, the State is failing to provide free or even affordable health services for the
poor Filipino majority. Filipinos are burdened with high out-of-pocket (OOP) expenses
comprising 44.4% of the country’s total health expenditures in 2023.' On the other
hand, the national government covered only 23%, local government at 9.3%, PhilHealth
10.2%, on-insurance corporations 7.3%, and insurance corporations 5.8 percent.” The

* https://psa.gov.ph/systenvfiles/sad/Press%20Release_PNHA 2023 pdf
2 “Reducing PhilHealth’s finances only makes it more dificult to meet its already unmet targets.” |BON
Foundation, 25 February 2025. Retrieved from https:/www.ibon.org/philhealth-finances-targets/


poorest households do not benefit from PhilHealth, even if they are the ones who should
be prioritized. Even with the PhilHealth’s ”No Balance Billing”, the covered indigents
still have no access to this so-called protection because of its limitation and lack of
availability in the regions where it is much needed.

Each Filipino spent P11,083 for health in 2023, which is more than 80% of the
P 13,420 monthly earnings of minimum wage earners in NCR.‘ Hospitalization costs in
private healthcare facilities are even expected to increase by 5 to 15 percent due to
inflation affecting medical supplies, equipment, medicines, and wages for healthcare
workers.

The Philippines (44%) has the third highest OOP payments among ASEAN
member states, behind Myanmar (65.1%) and Cambodia (61.2%).' Meanwhile, the
Philippines’ public spending on health, which was about 1.5 percent of the gross
domestic product (GDP), was much lower than that of Thailand, Vietnam, Singapore,
and Malaysia, which spent four times more.”

There is an urgent need to increase government spending on public health care.
“An explicit target for government expenditure on health services relative to GDP is a
potentially powerful tool for holding governments to account” in terms of the people’s
health, economic, social and cultural rights.*

Increased public spending in various countries quickly translates into improved
service.” The greater the level of government health spending as a percentage of GDP,
the lower the share of OOP payments in total health spending.'° Through public

3 *PhilHealth, FailHealth.” IBON Foundation, 2024. Retrieved from https:/Awww.ibon.org/philhealth-fail/
* Computed at P610/day NCR monthly minimum wage x 22 days

5 Baron, G. “Hospital rates set to rise as inflation hits medical sector.” Daily Tribune, 31 May 2025.
Retrieved from https:/itribune.net ph/2025/05/3 1/hospital-rates-set-to-rise-as-inflation-hits-medical-
sector

© “Trends in Philippine Health Expenditure." Congressional Policy and Budget Research Department,
February 2025. Retrieved from https://opbrd. congress. gov. phiwp-content/uploads/2025/03/FF2025-
14-TRENDS-IN-PHILIPPINE-HEALTH-EXPENDITURE pdf

* Charlotte Justine Diokno-Sicat, Valerie Gilbert Ulep, Robert Hector Palomar, Ricxie Maddawin, and
Mark Gerald Ruiz. “Underinvestment hampers growth of PH health sector.” Philippine Institute for
Development Studies, vol. 41 no. 2, 2023, p. 1. Retrieved from

https:/Ipidswebs.pids.gov. ph/CDN/document/pidsdm2302. pdf

® Mcintyre, Di, Filip Meheus, and John-Ame Rattingen. ‘What Level of Domestic Government Health
Expenditure Should We Aspire to for Universal Health Coverage?” Health Economics, Policy and Law
12.2 (2017): 125-137. Web. Retrieved from https:/www.cambridge.org/core/joumals/health-
‘economics-policy-and-taw/articlehwhat-level-of-domestic-government-health-expenditure-should-we-
aspire-to-for-universal-health-coverage/B03E4F AA9DB51F4C9738CB584C9C8B31

° Jowett M, Brunal MP, Flores G, Cylus J. Spending targets for health: no magic number. Geneva’
‘World Health Organization; 2016 (WHO/HISIHGF/HFWorkingPaper/16.1; Health Financing Working
Paper No. 1); http://apps. who inViris/bitstream/10665/250048/1/WHO-HIS-HGFHFWorkingPaper-
16.1-eng.pdf

*° Xu, Evans, Kawabata, Zeramdini, Klavus and Murray2003, as cited by Mcintyre D, Meheus F
Rettingen J-A. What level of domestic government health expenditure should we aspire to for
universal health coverage? Health Economics, Policy and Law. 2017;

https://pubmed.nebi.nim.nih. gov/28332456/


financing, all contribute fairly to the national budget, through progressive taxation,
according to the Civil Society Engagement Mechanism for UHC2030."' “A. 1-percent
increase in public health spending per capita may be related to an increase of about 15.1
percent to 17.9 percent in labor productivity in 5 years,” according to a study by State
think-tank Philippine Institute for Development Studies (PIDS).!?

Calls to increase government spending to at least 5% of GDP are supported by
various groups and organizations locally and globally. The 5% of GDP for health
spending appeared in WHO documents as early as 1981. Various local health groups
and people’s organizations have long called for 5% GDP public spending on health. In
2013, PIDS prodded the government anew to increase health spending to 5% of GDP.!?

A study in 2017 which analyzed the level of government spending needed to
reduce poverty, the costs of sufficient numbers of health workers and the cost of
providing 90% coverage of essential health services, concluded that a target government
expenditure equivalent to at least 5% of GDP is the most appropriate.”"*

The 5% of GDP translates to about P1.3 Trillion, based on the country’s GDP in
2024.'5 This can be achieved by rechanneling non-productive expenses like debt
servicing, which in 2025 will cost the country P2.1 Trillion,'® confidential and
intelligence funds, and pork barrel of lawmakers and similar expenditures to public
health and other social services. Progressive taxation like a wealth tax on the super-
rich as well as bigger taxes on big corporations can provide the needed additional funds.

This Bill amends Section 31 of Presidential Decree No. 1177, otherwise known.
as the "Budget Reform Decree of 1977" and Section 26, Chapter 4, Book VI of
Executive Order No. 292, otherwise known as the "Administrative Code Of 1987".

*' Refiloe Mabejane. “Why 5% of GDP.” Civil Society Engagement Mechanism for UHC2030, 1 July
2019. Retrieved from https://csemonline.netwp-content/uploads/2019/07/WHY-5-of-GDP-1.pdf
Ibid

* Cai Ordinario. “Government prodded anew to increase health spending to 5% of GDP.” Philippine
Institute for Development Studies, 4 September 2013. Retrieved from
https://pids.gov.ph/details/govemment-prodded-anew-to-increase-health-spending-to-5-of-gdp
Mcintyre, Di et al. “What level of domestic government health expenditure should we aspire to for
universal health coverage?." Health economics, policy, and law vol. 12,2 (2017): 125-137.
doi:10.1017/S17441331 16000414. Retrieved from https://pubmed.ncbi.nim.nih. gov/28332456/

*5 Computed from the data from openstat psa.gov.ph of P26,446,369,495 GDP for 2024 at current
prices.

'8 Ben Amold de Vera. “Record-high P16 6-tilion Philippine debt poses repayment pressures.”
Manila Bulletin, 1 April 2025. Retrieved from https://mb.com.ph/1/4/2025irecord-high-16-6-trilion-
philippine-debt-poses-repayment-pressures


In the light of the foregoing, immediate approval of this Bill is earnestly sought.

tb

Rep. ANTONIO L. TINIO Rep. RENEE LOUME M. CO
ACT Teachers Party-1 BATAAN Party-List



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

TWENTIETH CONGRESS
First Regular Session

HOUSE BILL No. 1973

Introduced by
ACT Teachers Party-List Rep. ANTONIO L. TINIO
and KABATAAN Party-List Rep. RENEE LOUISE M. CO

AN ACT
PROVIDING FOR THE AUTOMATIC APPROPRIATION FOR PUBLIC
HEALTH SERVICES, AMENDING SECTION 31 OF PRESIDENTIAL
DECREE NO. 1177 AND SECTION 26, CHAPTER 4, BOOK VI OF
EXECUTIVE ORDER NO. 292, OTHERWISE KNOWN AS THE
"ADMINISTRATIVE CODE OF 1987"

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

SECTION I. Short Title. This Act shall be known as the “Automatic Appropriation
Sor Public Health Services Act”.

SECTION 2. Declaration of Policy. Pursuant to Section 15, Article 11 of the 1987
Constitution the State hereby declares the policy of protecting and promoting the right
to health of the people and instilling health consciousness among them. Towards this
end, the State shall adopt an integrated and comprehensive approach to health
development, which shall endeavor to make essential goods, health and other social
services available to every Filipino at affordable cost.

SECTION 3. Automatic Appropriation of the equivalent of at least 5% of Gross
Domestic Product for Public Health Services. The State is hereby mandated to allot
the equivalent of at least 5% of the previous year’s Gross Domestic Product for public
health services.

Section 31 of Presidential Decree No. 1177 of July 30, 1977 entitled "Revising the
Budget Process in Order to Institutionalize the Budgetary Innovations of The New
Society” is hereby amended to read as follows:


"Section 31. Automatic Appropriations. All expenditures for (a) personnel
retirement premiums, government service insurance, and other similar
fixed expenditures, (B) PUBLIC HEALTH EXPENDITURES, ((b)] (C)
principal and interest on public debt, [(¢)] (D) national government
guarantees of obligations which are drawn upon, are automatically
appropriated: provided, that no obligations shall be incurred or payments
made from funds thus automatically appropriated except as issued in the
form of regular budgetary allotments.”

XXX

SECTION 4. Repealing Clause. Section 26, Chapter 4, Book VI of Executive Order
No. 292, otherwise known as the "Administrative Code of 1987" which reiterates in toto
Section 31 of Presidential Decree No. 1177 is likewise amended. Any other law,
presidential decree or issuance, executive order, letter of instruction, administrative
order, rule or regulation contrary to or inconsistent with the provision of this Act is
hereby repealed, modified or amended accordingly.

SECTION 5. Effectivity. This Act shall take effect after fifteen (15) days following

the completion of its publication in the Official Gazette or in a national newspaper of
general circulation.

Approved,