FIFTEENTH CONGRESS )
REPUBLIC OF THE PHILIPPINES —)
FIRST REGULAR SESSION )

HOUSE OF REPRESENTATIVES

Introduced by Representative Rufus B. Rodriguez and
Representative Maximo B. Rodriguez, Jr.

House Bill No._ 2939

EXPLANATORY NOTE

Article Il, Section 13 of the Constitution states 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. Section 15 of
Article Il also states that it is the policy to protect and promote the right to
health of the people and instill health consciousness among them. Further,
Section 11 of Article XIll states that 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 all the people at
affordable cost. There shall be priority for the needs of the underprivileged
sick, elderly, disabled, women, and children. The state shall endeavor to
provide free medical care to paupers.

Statistics show that 31% and 32.9% of pre-school and grade school
children, respectively, are underweight. It only shows that these children come
from families living below poverty line.

This bill seeks to establish the Children's Health Insurance Program.
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. This is in
line with the Millennium Development Goals of reducing child mortality, among
others,

In view of the foregoing, early passage of this bill is earnestly sought.

RUFYS B. RIGUEZ

My

MAXIMO B. RODRIGUEZ, JR.


FIFTEENTH CONGRESS )
REPUBLIC OF THE PHILIPPINES )
FIRST REGULAR SESSION )
HOUSE OF REPRESENTATIVES

Introduced by Representative Rufus B. Rodriguez and
Representative Maximo B. Rodriguez, Jr.

2939

House Bill No.

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:

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(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 e REMEDIAL, THERAPEUTIC OR
REHABILITATIVE SERVICES;

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(Ss) 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 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 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 | and Il 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. 1%.

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:

a) 00%;
b) x00;
¢) 0x, and
4) xx.

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. - 0x

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:

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20x

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. -
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 circulation, whichever comes first.

Approved,