The Department of Budget and Management has denied its role in the 2024 GAA which saw the reduction of coverage for 30 million Filipinos. The fact remains that 30 million of 50 million indirect members and dependents have no coverage because of the 2024 GAA which was reviewed and approved by DBM before the President signed it in December. 


“DBM did agree to cover 21 million indirect members in the NEP, but failed to point out the impact of any reduction to the bicam which transferred 40b from PHIC to DOH’s MAIFIP program. This directly resulted in the current situation where only 10.626m indirect members are covered and not 21.161 as originally intended by PHIC,” Dr. Perez noted.


DBM’s technical reviews which are conducted a few months before the NEP is submitted to Congress, usually establishes the legal basis for the requests of agencies. The PhP 80 billion requested by PHIC was a tier 1 item that should have remained in the GAA, since it is covered by RA 10606, the 4Ps institutionalization law and laws on senior citizens. All of these were probably not brought up by DBM during the Bicam and the President was not properly advised by that agency.


“DBM cannot deny its role in allowing the reduction of the budget for indirect members, particularly in the final stages of the budget process,” Dr Perez asserted.

DBM also recommended a premium of P3,000 for NHTS and P5,000 for senior citizens next year, which is below the P6,000 annual premium to retain membership. This will reduce coverage to only 6 months for 4Ps and 10 months for senior citizens.


By recommending these cuts in the 2025 NEP DBM is pursuing a policy of reduction in support to the social health insurance program which started with the transfer of P89.9billion from the funds intended for indirect contributors.


In its response to MAG’s press statement, DBM seems to equate the National Health Insurance Program with the MAIFIP (Medical Assistance to Indigents and Financially Incapable Patients) program of DOH. MAIFIP is intended to top up what PhilHealth provides and logically government should fund the indirect contributors first and use the MAIFIP as a funding of last resort.


No one knows who will be affected by a health condition at any time, which is why coverage must be universal. The fact that only 15pct of indirect members made claims cannot be a reason to deny everyone, particularly the poor and elderly, of coverage. By only proposing 14 million to be covered in 2025, has DBM pre-identified who will get sick or not next year?


When DBM says that PHIC can cover the needs of 30 million without premium coverage, we would like to remind the agency of the following provision of RA 10606:

SEC. 12. Entitlement to Benefits. – A member whose premium contributions for at least three (3) months have been paid within six (6) months prior to the first day of availment, including those of the dependents, shall be entitled to the benefits of the Program: Provided, That such member can show that contributions have been made with sufficient regularity: Provided, further, That the member is not currently subject to legal penalties as provided for in Section 44 of this Act. 


So how can those removed from membership avail of benefits when government has not paid their premiums as DBM has recommended?


“Any legal action to be taken by a government agency against myself will be an opportunity to clarify these matters which affect the health of all Filipinos,” Dr. Perez said.


For inquiries, please contact:

Ms. Edeliza P. Hernandez, RN

Medical Action Group

Email: ehernandez@magph.org