FOURTEENTH CONGRESS OF THE 
) 
REPUBLIC OF THE PHILIPPINES 
) 
First Regular Session 
1 
S E N A T E  
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Introduced by Senator Loren Legarda 
EXPLANATORY NOTE 
As provided in the 1987 Constitution of the Philippines, 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 11, Section 13) 
Statistics show that 31 percent of the children in pre-school are underweight, 
while for those of school-age children, 32.9 percent. Of these figures, most come from 
families that are living within the poverty belt, if not below it. Undernutrition paves the 
way for diseases and weaknesses in health, and more often than not, results in lifetime 
disability. 
While the National Health Insurance Act provides a system wherein the poor can 
avail of health services through their membership in the National Health Insurance 
Program (NHIP), there are gaps that need to be filled - particularly on children. 
This bill seeks to fill the gaps by increasing the scope and coverage of the NHIP 
to cover the health needs of the children. In the proposed measure, the Children's 
Health Insurance Program (CHIP) will be put in place. Under this program, eligible 
children coming from low-income families shall be entitled to a full range of health 
services that include, but do not limit to, regular check-ups, immunizations, 
prescription drugs, lab tests, dental care. 
Moreover, this proposed legislation is in line with the Millennium Development 
Goals of reducing child mortality, among others. Recognizing the importance of 
children's welfare, especially on health, and likewise giving material support through 
such a measure, is a step towards fulfilling the goals of providing a world fit for 
children to live in. 
In view of the foregoing, the passage of this bill is earnestly sought. 
Senator 


FOURTEENTH CONGRESS OF THE 
1 
REPUBLIC OF THE PHILIPPINES 
1 
First Regular Session 
1 
Introduced by Senator Loren Legarda 
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 House of Representatives of the Philippines in Congress 
assembled: 
SECTION 1. Section 4 of Republic Act No. 7875 is hereby amended to 
read as follows: 
“SEC. 4. Definition of Terms. - For the purposes of this Act, the 
following terms shall be defined as follows: 
xxx 
(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 I retiree member. 
xxx 
(dd) QUALIFIED CHILD 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 
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POVERTY LINE, AND DETERMINED 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. Xxx. It shall initially consist of Programs I 
and I1 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: 
“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: 
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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: 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 law and have paid at least one hundred twenty (120) monthly 
contributions; [and] 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 contribution schedule to be determined by the Corporation on the 
basis of applicable actuarial- studies and in accordance with the following 
guidelines: 
xxx 
xxx 
xxx 
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: 
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SEC. 30. Payment for a Child Beneficiary’s Contributions. - 
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 10. Repealing Clause. All laws, presidential decrees, executive 
orders, rules and regulations or parts thereof which are deemed inconsistent wit the 
provisions of this Act are hereby repealed, amended, or modified accordingly. 
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 circulatibn, whichever comes first. 
Approved, 
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