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FOURTEENTH CONGRESS OF THE 
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REPUBLIC OF THE PHILIPPINES ) 
Second Regular Session 
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9 APR 14 P6 37 
SENATE 
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Introduced by Senator JUAN MIGUEL F. ZUBlRl 
EXPLANATORY NOTE 
Article II, Section 13 of 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. 
Access to basic health services is one of the major challenges for children 
everywhere. According to a U.S.-based charity, more than 200 million children 
worldwide do not get basic health care, leading to nearly 10 million deaths of children 
under the age of 5 annually from treatable ailments like diarrhea and pneumonia. 
In the Philippines, a UNICEF study shows that roughly 2.4 million Filipino 
children 0 to 5 years old are underweight, and 26.3 per cent are stunted. The study also 
reveals that 23 out of 1,000 children die before reaching the age of 1; 28 out of 1,000 
children die before reaching the age of 5; and, only 7 out of 10 infants are immunized. 
The 2006 UNDP Human Development Report reveals 19 per cent of total population is 
undernourished. All of these are critical issues that seek immediate solutions to improve 
children's health care. 
This bill aims to increase and expand the coverage of our National Health 
Insurance Program to include children. The proposed Children's Health Insurance 
Program seeks to benefit around 14 million Filipino children by providing eligible 
children with a wide range of health care services like regular check-ups, 
immunizations, prescription drugs, laboratory tests and hospital or clinic visits. 
Hence, immediate passage of this bill is earnestly sought. 


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UI-riL... 
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FOURTEENTH CONGRESS OF THE 
) 
REPUBLIC OF THE PHILIPPINES ) 
Second Regular Session 
) 
9 
APR 14 P6:W 
SENATE 
S. No. 315 
{TEz'r i\/F r: 8: /I 
Introduced by Senator JUAN MIGUEL F. ZUBlRl 
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 R.A. 9241 AND FOR OTHER PURPOSES 
Be it enacted by the Senate and the House of Representatives of the Philippines in 
Congress assembled: 
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2 follows: 
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SECTION 1. Section 4 of Republic Act No. 7875 is hereby amended to read as 
"SEC. 
4. Definition of Terms. - For the purposes of this Act, the following 
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xxx 
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(d) CHILD HEALTH 
terms shall be defined as follows: 
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SSISTANCE - A RP IGE 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 
pensionerhetiree member. 
xxx 
(dd) QUALIFIED CHILD MEMBER - ANY CHILD OF A LOW- 
INCOME FAMILY UNDER 6 YEARS OF AGE OR OVER BUT WHO ARE 


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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 DETERMlNED AS SUCH BY THE PERTINENT 
GOVERNMENT AGENCY." 
SECTION 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 affordable, acceptable, available and accessible health 
care services for all citizens of the Philippines, in accordance with the policies 
and.specific provisions of this Act. This social insurance program shall serve as 
the means for the healthy to help pay for the care of the sick and for those who 
can afford medical care to subsidize those who cannot. It shall initially consist of 
programs I and II of Medicare and be expanded progressively to constitute one 
universal health insurance program for the entire population. 
IT 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." 
SECTION 3. Section 6 of the same Act shall now read as follows: 
"SEC. 6. Coverage. - 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 have reasonable access to adequate and 
acceptable health care services." 
SECTION 4. Section 7 of the same Act shall now read as follows: 
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"SEC. 7. Enrollment. - The Program shall enroll beneficiaries in order for 
them to be placed under coverage that entitles 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 being maintained. The enrollment shall proceed 
in accordance with these specific policies: 
a) xxx; 
b) xxx; 
c) xxx; and 
d) xxx. 
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." 
SECTION 5. Section 12 of the same Act shall now read as follows: 
"SEC.12. Entitlement to Benefits. -xxx 
The following need not pay the monthly contributions to be entitled to the 
Program's benefits: 
a) Retirees and pensioners of the SSS and GSlS prior to the effectivity of 
this Act; 
b) Members who reach the age of retirement as provided for by law and 
have paid at least one hundred twenty (120) monthly contributions; [and] 
c) Enrolled indigents; AND 
D) QUALIFIED CHILD OF LOW-INCOME FAMILIES. 
SECTION 6. Section 28 of the same Act is hereby amended to read as follows: 
"SEC. 28. Contributions. - All members of the Program shall contribute to 
the Fund, in accordance with a reasonable, equitable and progressive 
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contribution schedule to be determined by the Corporation on the basis of 
applicable actuarial studies and in accordance with the following guidelines: 
a) xxx 
b) xxx 
c) xxx 
D) CONTRIBUTIONS MADE IN BEHALF OF A QUALIFIED CHILD 
MEMBER SHALL NOT EXCEED THE MINIMUM CONTRIBUTIONS SET FOR 
EMPLOYED MEMBERS.” 
SECTION 7. A new Section 30 is hereby added to read as follows: 
SEC. 30. PAYMENT FOR A CHILD BENEFICIARY’S CONTRIBUTIONS. 
- AN INITIAL AMOUNT OF THIRTY MILLION PESOS (P30,000,000.00) 
IS 
HEREBY APPROPRIATED FOR THIS PURPOSE FOR THE FIRST YEAR OF 
ITS 
IMPLEMENTATION. THEREAFTER, 
THE 
CONTRIBUTIONS FOR 
QUALIFIED 
CHILDREN 
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. 
SECTION 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. 
SECTION 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. 
SECTION I O .  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. 
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SECTION 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) 
newspapers of general circulation, whichever comes first. 
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Approved, 
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