FIFTEENTH CONGRESS
First Regular Session

2441

House Bill No.

Introduced by HONORABLE IGNACIO T. ARROYO

EXPLANATORY NOTE

The 1987 Constitution provides that 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 (Article ll, Section 13).

For reason of poverty, a significant number of our children are likely to be illiterate,
malnourished and prone to abuse and physical violence. Even where health care services
are available, the cost of seeking care may delay or prevent poor households from accessing
them. While the National Health Insurance Act or PHILHEATH Act provides all citizens,
especially the poor, financial access to health services through a National Health Insurance
Program (NHIP) which resulted in marked gains in the delivery of basic health care services
in the country, there still remain major challenges facing the country’s health sector.

For instance, 2 report from the United Nations Children's Fund (UNICEF) estimated that
around three (3) million children in the Philippines are suffering from stunted growth as a
result of chronic maternal and childhood undernutrition. These children are susceptible to
different illnesses. While insurance can provide financial protection in times of ill health, in
the Philippines however, the World Health Organization reports that only 11.3% of
members of the Philippine Health Insurance Corporation are poor. Lacking insurance and
savings, poor households must often borrow money or sell productive assets to cover the
cost of seeking care especially for their children.

Hence, this measure proposes to increase and expand the scope and coverage of our
National Health Insurance Program to include children, to make then not only dependents
but beneficiaries as well. The Children’s Health Insurance Program (CHIP), as proposed, is
designed for low-income families who cannot afford to insure the health needs of their
children.

Hence, immediate passage of this bill is earnestly sought.

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Representative
5" District, Negros Occidental


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FIFTEENTH CONGRESS
First Regular Session

2444

House Bill No.

Introduced by HON. IGNACIO T. ARROYO

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
BY REPUBLIC ACT 9241 AND FOR OTHER PURPOSES

Be enacted by the Senate and the House of Representatives in Congress duly assembled:
SECTION 1, Section 4 of Republic Act No. 7875 is hereby amended to read as follows:

“Sec. 4 Definition of Terms-For the purpose of this act, the following terms
shall be defined as follows:
20%

(d) CHILD HEALTH ASSISTANCE - A RANGE OF HEALTH CARE AND SUPPORT
SERVICES INCLUDING, BUT NOT LIMITED TO, PHYSICIAN SERVICES AND ANY OTHER
MEDICAL, DIAGNOSTIC, SCREENING, PREVENTIVE, RESTORATIVE, REMEDIAL,
‘THERAPEUTIC OR REHABILITATIVE SERVICES;

Xxx

{s) MEMBER-Any person whose premiums have been regularly paid to the
National Health Insurance Program. He may be a paying member, an indigent
member, a QUALIFIED CHILD MEMBER, or a pensioner/ retiree member.

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(dd) QUALIFIED MEMBER- ANY CHILD OF A LOW INCOME FAMILY UNDER 6
YEARS OF AGE OR OVER BUT WHO ARE UNABLE TO FULLY TAKE CARE OF
THEMSELVES OR PROTECT THEMSELVES FROM ABUSE, NEGLECT, CRUELTY,
EXPLOITATION OR DISCRIMINATION BECAUSE OF A PHYSICAL, MENTAL DISABILITY
OR CONDITION AND WHOSE FAMILY IS BELOW POVERTY LINE, AND DETERMINED AS
SUCH BY THE PERTINENT GOVERNMENT AGENCY

Sec. 2 Section 5 of the same act shall now read as follows:

“Sec. 5. Establishment and Purpose. - There is hereby created the National
Health insurance Program which shall provide health insurance coverage and ensure


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H.B. No.

2441

SHALL INITIATE AND EXPAND THE PROVISION OF CHILD HEALTH ASSISTANCE TO
INCLUDE A CHILD HEALTH INSURANCE PROGRAM FOR UNINSURED, LOW-INCOME
CHILDREN IN AN EFFECTIVE AND EFFICIENT MANNER THAT IS COORDINATED WITH
OTHER SOURCES OF HEALTH BENEFITS COVERAGE FOR CHILDREN. xxx.

Sec. 3 Section 6 of the same act shall now read as follows:

“Sec. 6. All citizens of the Philippines, WHETHER CHILD OR ADULT shall be
covered by the National Health Insurance Program. In accordance with the
principles of universality and compulsory coverage enunciated in Section 2 (b) and 2
(1) hereof, implementation of the program shall, furthermore, be gradual and
phased in over a period of not more than fifteen (15) years: Provided, that the
program shall not be made compulsory in certain provinces and cities until the
corporation shall be able to ensure that members in such localities shall reasonable
access to adequate and acceptable health care services”

Sec. 4 Section 7 of the same act shall now read as follows:

Sec. 5 Section 12 of the same act shall now read as follow:

“Sec. 7 enrollment... The program shall enroil beneficiaries in order for them
to placed under coverage that entities them to avail of benefits with the assistance
of the financial arrangements provided by the Program. The process of enrollment
shall include the identification of beneficiaries, issuance of appropriate
documentation specifying eligibility to benefits, and indicating how membership was
obtained or is maintained. The enrollment shall proceed in accordance with these
specific policies:

{a) 120000

{b) 12000

(c) »000% and

(d) 20000

All indigents AND QUALIFIED CHILD MEMBER not enrolled in the program
shall have priority in the use and availment of the services and facilities of
government hospitals, health care personnel and other health organizations:
Provided, however, that such government health care providers shall ensure that
said indigents AND QUALIFIED CHILD MEMBER shall subsequently be enrolled in the
program.”

“Sec. 12. Entitlement of Benefits. xxx

The following need not pay the monthly contributions to be entitled to the
program's benefits: Retirees and pensioners of the SSS and GSIS prior to the
effectivity of this act; Members who reach the age of retirement as provided for by


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H.B. No.

2441 :

“Section 28. Contributions.- all members of the program shall contribute to
the fund, in accordance with a reasonable. Equitable and progressive contribution
schedule to be determined by the corporation on the basis of applicable actuarial
studies and in accordance with the following guidelines:

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“CONTRIBUTIONS MADE IN BEHALF OF A QUALIFIED CHILD MEMBER SHALL
NOT EXCEED THE MINIMUM CONTRIBUTIONS SET FOR EMPLOYED MEMBERS”

Sec. 7. A new Section 30 is hereby added to read as follows:

“Sec. 30. Payment for a Child Beneficiary’s Contribution.-
CONTRIBUTIONS FOR QUALIFIED CHILOREN BENEFICIARIES SHALL BE
SUBSIDIZED PARTIALLY BY THE LOCAL GOVERNMENT UNIT WHERE THE
MEMBER RESIDES. THE CORPORATION SHALL PROVIDE COUNTERPART
FINANCING EQUAL TO THE LGUS SUBSIDY FOR CHILDREN. THE SHARE OF THE
LGUS SHALL BE PROGRESSIVELY INCREASED UNTIL SUCH TIME THAT ITS
‘SHARE BECOMES EQUAL TO THAT OF THE NATIONAL GOVERNMENT.”

Sec. 8 Implementing Rules and Regulations. - Within thirty (30) days from the effectivity of
this Act, the Board of Directors of the Philippine Health Insurance Corporation (PHIC) shall
convene to formulate the rules and regulations for the implementation of this Act.

Sec. 9 Separability Clause. - If any part or provision of this Act shall be held unconstitutional
or invalid, other provisions which are not affected thereby shall continue to be in full force
and effect.

Sec. 10 Repealing Clause. - All laws, presidential decrees, executive orders, rules and
regulations or parts thereof which are deemed inconsistent with the provisions of this Act
are hereby repealed, amended or modified accordingly.

Sec. 11 Effectivity Clause. - This act shall take effect fifteen (15) days following its full and
complete publication in an official gazette or in at least two (2) newspaper of general
circulation, whichever comes first.

Approved,