Court of Appeal Decision Paves the Way for the New Social Health Insurance Fund (SHIF)

Kenya’s healthcare landscape stands on the precipice of change. The Court of Appeal recently lifted a temporary block on the implementation of the Social Health Insurance Act 2023, paving the way for the rollout of the new Social Health Insurance Fund (SHIF). This ambitious plan aims to revolutionize access to healthcare for all Kenyans, replacing the existing National Health Insurance Fund (NHIF).

What is SHIF?

SHIF marks a significant shift in healthcare financing. Unlike NHIF, it establishes three distinct funds:

• Primary healthcare fund – This focuses on preventive and outpatient care at the community level.
• Social health insurance fund – This covers inpatient and specialized care for a wider range of illnesses and injuries.
• Emergency, Chronic and Critical Illness Fund – This provides financial protection for expensive treatments like dialysis and cancer care.

Proposed Contributions:

The 2024 regulations propose a 2.75% contribution rate based on gross salary. While the final rate awaits confirmation, a comparison with current NHIF deductions clarifies the potential impact:

Implications of SHIF

Currently, insurance relief is granted at the rate of 15% of the qualifying premiums contributed to a medical scheme (including NHIF) paid but capped to a maximum of Kes 5,000 per month or Kes 60,000 per year.

While SHIF contributions may be higher than current NHIF deductions for many individuals, it’s important to consider the broader coverage and potential benefits offered by the new system. Public feedback on the draft regulations is ongoing until February 9th, 2024.

The implementation of SHIF is an ongoing process. Consider participating in public discussions and consultations to contribute to shaping a more equitable and sustainable healthcare system for all Kenyans. Stay tuned for updates on the final contribution rate and implementation timeline.

While this article is for public knowledge, individual circumstances may necessitate professional advice. Engage with our team at Ndakala Advisory LLP through the following channels;