The Kenyan government’s commitment to achieving Universal Health Coverage (UHC) is now centered around the new Social Health Insurance Fund (SHIF), which is set to replace the existing National Health Insurance Fund (NHIF).
Although the implementation has experienced some delays, mass registration began on July 1, 2024, with the full launch slated for October 1, 2024.
The government’s goal is to ensure that all Kenyans register for the new Fund.
Under SHIF, employees in the formal sector are required to contribute 2.75 percent of their monthly salaries, while those in the informal sector will need to pay Sh.500 each month.
This is a change from the NHIF system, where employee contributions ranged between Sh.1,400 to Sh.1,700 depending on their salaries, with employers matching the contributions.
Self-employed individuals had been making a voluntary contribution of Sh.500.
The new program aims to include over 17 million youths who are not currently NHIF members, making it mandatory for all individuals over the age of 25, including the unemployed, to contribute to SHIF.
Health Cabinet Secretary Susan Nakhumicha recently indicated that the government will assess the economic activities of unemployed and self-employed individuals, such as their mobile money transactions, to determine their ability to contribute.
She stated, “If you live in a grass house, it cannot be hidden. We will observe the economic characteristics of the unemployed to see how they will contribute,” in June 2024.
According to Section 26 (5) of the Social Health Act 2023, registration with SHIF is compulsory for all Kenyans and foreign residents in Kenya.
Those who fail to register will be denied access to government services and will incur a penalty of two percent of the outstanding amount for each month of non-compliance.
The law stipulates, “A person who is registerable as a member under this Act shall produce proof of compliance with the provisions of this Act on registration and contribution as a precondition of dealing with or accessing public services from the national government, county government or national or county government entities.”
Employers who fail to remit contributions without a valid reason could face fines up to Sh.2 million, a three-year jail term, or both.
Providing false information during registration to receive preferential treatment or benefits can result in a fine up to Sh.1 million, 60 months imprisonment, or both.
Misappropriation of Fund assets can lead to a prison term of up to five years or a fine up to Sh.10 million, or both.
Additionally, impersonating someone else to obtain benefits carries a penalty of a Sh.1 million fine or a three-year jail term, or both.
Healthcare facilities found to be falsifying information to defraud the government may be fined Sh.2 million and risk suspension or removal from the list of contracted healthcare providers.
Suspended facilities will be publicly listed in the Gazette and will cease to receive any benefits from the Fund.