HOUSE OF REF
RECENT
eS
DATE
UNE:
BY:

SEVENTEENTH CONGRESS OF THE )
REPUBLIC OF THE PHILIPPINES)
First Regular Session )

HOUSE OF REPRESENTATIVE!

H.NoLB75-

RECISTRA DON UNIT
BILLS AND NUEX SERVICE

Introduced by Representative VILMA SANTOS-RECTO.
6" District of Batangas

AN ACT
EXPEDITING UNIVERSAL HEALTHCARE UNDER THE NATIONAL HEALTH
INSURANCE PROGRAM AND IMPROVING THE PHILIPPINE HEALTH
INSURANCE CORPORATION’S (PHILHEALTH) BENEFIT PACKAGES,
PROVIDING FUNDS THEREFOR AND FOR OTHER PURPOSES

Explanatory Note

Universal healthcare also known as universal health coverage means that the entire
population can use promotive, preventive, curative and palliative health services that they need,
of sufficient quality to be effective, while also ensuring that the use of these services does not
expose them to financial hardship'.

In order to attain universal healthcare in the country, the National Health Insurance
Program (NHIP) was instituted. It is meant to provide every Filipino an insurance coverage
under the state-run Philippine Health Insurance Corporation (Philhealth). Data obtained from
Philhealth indicate that 93.5 million Filipinos or about 92% of the entire population have already
been covered under the program as of December 2015. About half of them are indigents who are
subsidized by the government, while the rest are comprised of paying individuals from the
formal and informal economies and lifetime members.

Last year’s financial statements of Philhealth show that the Corporation collected P96.7
billion from premium contributions of all its members, including the government subsidy for
indigents. Accordingly, it paid out about P97 billion for benefit payments covering about 8.4
million claims. If we are to treat each claim as one patient, the numbers would imply that on the
average, each person who got sick and availed of Philhealth benefits in 2015 practically got
P11,500 each, a small amount to cover medical expenses in a year.

This bill aims at expediting the attainment of universal healthcare by providing coverage
to all Filipinos to eventually close the gap from the current 92% to 100%. The default position
should be that if you are a citizen of this country, you will be qualified to avail of its benefits,
regardless if you have a Philhealth identification card or not.

This bill also proposes to improve the benefit packages being offered by Philhealth by
increasing the amount of benefits to lessen the out-of-pocket expenses on the part of the
members. Improving the benefit packages would also entail the inclusion of preventive and
promotive health services to lessen the chances of confinement and to encourage a healthy
lifestyle among the population.

The funding requirements to support the aforesaid objectives shall be sourced from the
following: a) total sin tax collection, except those earmarks mandated by law; b) the 50% share
of the national government in the aggregate gross earnings of the Philippine Amusement and
Gaming Corporation (PAGCOR); and c) The Charity Fund of the Philippine Charity and
Sweepstakes Office (PCSO). These fund sources are expected to infuse more than a hundred

ENTATIVES



s to Philhealth that can be tapped to expedite the provision of healthcare coverage to
ino population while at the same time improving their benefits.

‘Using the above-mentioned funds for universal healthcare will also address the issues on

transparency, accountability and effective utilization of government funds, particularly the

PAGCOR income and the PCSO charity fund which have been left to the discretion of its
respective Boards in the past years.

The amount to be allocated for universal healthcare shall i
General Appropriations Act.

In view of the foregoing, the approval of the bill is earnest

VILMA SANTOS-RECTO



SEVENTEENTH CONGRESS OF THE )
REPUBLIC OF THE PHIILIPPINES )
First Regular Session )

HOUSE OF REPRESENTATIVES,

H. No, L875

Introduced by Representative VILMA SANTOS-RECTO.
6" District of Batangas

AN ACT
EXPEDITING UNIVERSAL HEALTHCARE THROUGH THE NATIONAL HEALTH
INSURANCE PROGRAM AND IMPROVING THE PHILIPPINE HEALTH
INSURANCE CORPORATION’S (PHILHEALTH) BENEFIT PACKAGES,
PROVIDING FUNDS THEREFOR AND FOR OTHER PURPOSES,

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

CTION 1. Short Title. This Act shall be known as the “Enhanced Universal Healthcare
Act of 2016".
SI

2. Declaration of Policy. ~ It is hereby declared as the policy of the State to adopt an
integrated and comprehensive approach to health development which shall endeavor to. make
essential goods, health and other social services available to all people at affordable cost and to
provide free medical care to indigents. Towards this end, the State shall provide comprehensive
health care services to all Filipinos through a universal and socialized health insurance program.

SEC. 3. Universal Healthcare. ~ The Philippine Health Insurance Corporation (Philhealth)
shall provide all Filipino citizens an insurance coverage under the National Health Insurance
Program (NHIP). Upon implementation of the universal coverage, all Filipinos shall be covered and
shall not be required to present a Philhealth identification card to avail of health insurance benefits.
In lieu thereof, any valid identification card shall be honored.

SEC. 4, Improved Benefit Packages. ~ The Philhealth shall study and implement adjustments
to improve its benefit packages: Provided, That the improvement of benefit packages shall take effect
not later than one year upon the effectivity of this Act: Provided, further, That the improved benefit
packages shall guarantee an annual benefit of at least Thirty Thousand Pesos (P30,000) for each
Philhealth member: Provided, finally, That the improved benefit packages shall include promotive
and preventive healthcare services.

SE

.. Fund Sources. ~ The fund requirements to implement this Act shall be sourced from

the following:

a, Total sin tax collections as provided for in Republic Act (R.A.) No. 10351 or the Sin Tax
Law: Provided, That the mandated earmarks as provided for in R.A. Nos. 7171 and 8240

shall be retained;

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b. The 50% national government share from the income of the Philippine Amusement and
Gaming Corporation (PAGCOR) as provided for in Presidential Decree No. 1869, as
amended or the PAGCOR Charter; and

c. The Charity Fund of the Philippine Charity and Sweepstakes Office (PCSO) as provided for
in R.A. No, 1169, as amended or the PCSO Charter.

The equivalent amount shall be included in the General Appropriations Act (GAA) as subsidy

to Philhealth under the budget of the Department of Health (DOH).

SEC. 6. Implementing Rules and Regulations, ~ Within sixty (60) days upon effectivity of this

Act, the Department of Finance (DOF), PAGCOR, PCSO, DOH, Philhealth and the Department of
Budget and Management (DBM) shall promulgate the necessary rules and regulations for the proper
implementation of this Act.

SEC. 7. Separability Clause. — If any provision of this Act is subsequently declared

unconstitutional, the validity of the remaining provisions hereof shall remain in full force and effect.

SEC. 8. Repealing Clause. — All laws, decrees, executive orders, rules and regulations and

other issuances or parts thereof which are inconsistent with this Act are hereby repealed or modified
accordingly,

SEC. 9. Effectivity. ~ This Act shall take effect fifteen (15) days after its publication in the

Offficial Gazette or in any two (2) newspapers of general circulation.

Approved,