Narok County Senator Ledama Olekina has rejected the Social Health Authority (SHA) setup, which requires mandatory insurance for already-insured Kenyans.
Ledama has called for an urgent review and implementation of the SHA insurance arrangements to make the arrangement reasonable.
According to the senator, the current arrangement regarding SHA insurance is unnecessary, unreasonable, and counterproductive.
“We must urgently review and correct the current SHA Insurance arrangement. Forcing SHA on people who already have valid insurance is unnecessary, unreasonable, and counterproductive,” Ledama Olekina stated.
He further noted that the current SHA setup is alleged to distort claim processing, making the insurers uneasy and demanding confirmation that SHA will pay 30% before the insurer honors their 70% share.
Senator Olekina emphasized that following the uncertainty in the fulfillment of the obligation by SHA, they have been obstructing care, and hence the shifting of unfair burdens onto hospitals.
The lack of an appropriate SHA arrangement is therefore limiting the insurance from meeting the initial purpose set during the establishment of the SHA system, according to the senator.
Also Read: SHA Responds After Exposé on AI System Overcharging Poor Kenyans
Public Reaction to Senator Olekina SHA Arrangement Rejection
Following Senator Olekina’s public rejection of the current SHA arrangement that imposes mandatory insurance for all Kenyans, including the insured ones, the public holds different opinions, with some blaming the SHA system and others supporting it.
According to Ouma Joseph, current SHA arrangements are more of a tax-return system than a universal care system, as it was established to be.
Citing the difference in the automated premiums and the service provision, Ouma expresses his dissatisfaction with the current insurance arrangement.
“SHA should genuinely be a universal care, not a tax return scheme. The automated premiums are high with low service to people with low incomes. Instead, why not everyone earning less than 40k pm pay 400 health + 100 last expense cover,” Ouma noted
In support of Senator Olekina’s rejection, a member of the public, Kibet Korir, outlined that SHA should complement the existing insurance and not become a bureaucratic gatekeeper that is pushing hospitals into financial limbo.
Despite some publics supporting the SHA system for already-insured Kenyans and calling for the implementation of the insurance arrangement, others have stated that Senator Olekina needs to take a stand, as he was an early supporter of SHA.
Also Read: Breakdown of All Services Covered by SHA and Payouts Reserved for Each
SHA Deduction Rule on Kenyans
Under the Social Health Insurance Act 2023, which established SHA to replace the National Hospital Insurance Fund (NHIF).
Every Kenyan must currently register with the SHA as part of the Universal Health Coverage (UHC).
In addition to registration, the employer deducts a mandatory 2.75% contribution to SHIF from salaried employees’ gross income.
Further, employees in the household and informal sectors, based on their declared income, receive a minimum of KSh. A mandatory monthly contribution of 300 is imposed through the SHA.
According to the government, the SHA deductions are mandatory for every Kenyan due to risk pooling, solidarity, equity, and the expansion of the revenue base.
Kenyan with private insurance have to make the mandatory 2.75% contribution either directly or through deductions on the payroll, with private insurers demanding that the only cover insurance after SHA covers its shares.
