Health Cabinet Secretary Susan Nakhumicha has explained why EduAfya Medical Scheme will be phased out once the Social Health Insurance Act, 2023 becomes operational.
The CS said the Sh4.6 billion allocated to the scheme will now be transferred to the Primary Healthcare Fund where learners will now be covered alongside their households.
“All students are going to be covered under their households because it does not make sense to cover a student who comes from a household then the rest of the household is not covered,” the CS said.
Nakhumicha spoke on Thursday while on a working tour of Western Kenya during a Universal Health Coverage spot-check in Busia County.
The CS said the visit focused on low-level facilities where the spot-check was to ensure the facilities have healthcare workers and medicines.
The EduAfya Medical Scheme became effective in May 2018 following a directive from former President Uhuru Kenyatta and it covered learners in public secondary schools across the country.
It was facilitated by the Ministry of Education through the Free Day Secondary Education which paid premiums for over 3.4 million learners.
Between 2019 and 2022, the government spent Sh9.5 billion on the scheme.
On November 30, 2023, the National Health Insurance Fund (NHIF) told Parliament that the programme would die a natural death once NHIF is replaced with a new fund.
NHIF Chief Executive Officer Elijah Wachira told the National Assembly Petitions Committee that NHIF would terminate all service provider contracts under EduAfya by December 31, 2023.
He said schools would have to look for another health insurer since NHIF would now be non-existent.
“By the end of the year, NHIF will run down all the contracts it had with the Ministry of Education and therefore they will have to look for a new service provider,” Wachira said.
NHIF is set to be replaced by three health funds upon the implementation of the Social Health Insurance Act, of 2023.
These are the Primary Healthcare Fund, the Social Health Insurance Fund and the Emergency, Chronic And Critical Illness Fund.
The court, however, stopped the implementation of the Social Health Insurance Act, 2023, the Primary Health Care Act, 2023 and the Digital Health Act, 2023 pending the hearing of a case on February 7, 2024.
Justice Chacha Mwita said he was satisfied that the petition filed by Joseph Aura raises important constitutional and legal questions that deserve urgent and serious consideration.
Nakhumicha said once the court case is concluded and the Acts implemented, the ministry will prioritise the formation of the Social Health Authority which will be tasked with managing the three health funds.
“We have a slight setback from the court case but I want to assure Kenyans at large that immediately this court case is out of my way, I will only need two weeks to roll out and ensure that all those Kenyans who are paying a minimum of Sh500 NHIF will now come to Sh300,” she said.
The halting of the implementation of the three health Acts is currently a hot topic with President William Ruto on Tuesday slamming the Judiciary with allegations of colluding with cartels to frustrate reforms in the health sector.
