THE Philippine Health Insurance Corp. (PhilHealth) said it is eyeing to cover 18% of hospital bills of Filipinos in 2025 to fulfill its mandate of healthcare accessibility under the Universal Healthcare (UHC) Act.
In a hearing on PhilHealth lawsuits on Wednesday, Supreme Court (SC) Associate Justice Jhosep Y. Lopez questioned PhilHealth Senior Vice-President Renato L. Limsiaco, Jr., on what would be the ideal case rate that would allow the agency to adhere to its mandate in the UHC Act — to not have any Filipino family suffering as a consequence of one’s sickness.
Mr. Limsiaco said in mixed English and Filipino, “PhilHealth’s target for the year 2025 is 18%, your honor, it would cover 18%.”
The magistrate countered, “Should it not be 50%? Would we not be able to reach that point?”
“As we progress with the implementation in the coming years, [PhilHealth] has a national health financing strategy set up through our Department of Health,” Mr. Limsiaco said. “PhilHealth is going to cover, if I’m not mistaken, 28% by 2028.”
Case rate refers to the portion of one’s hospital bill covered by PhilHealth.
PhilHealth is facing lawsuits questioning the transfer of P89.9 billion of its funds to the national Treasury.
Mr. Lopez, who suffered from esophageal cancer two years ago, shared that he incurred a P7-million bill after over two months of confinement in a hospital.
PhilHealth only covered P50,000 despite his being a contributor since 1985, he noted. This is only less than 2%, he added.
According to Mr. Limsiaco, the average case rate of Filipinos varies per patient, but the average is P10,000.
The high court will continue its fifth hearing on April 3, 2025, Thursday.
In 2024, the government initiated the transfer of P89.9 billion from PhilHealth to the national Treasury, labeling these as “excess funds.” The money was supposed to fund various projects, including infrastructure and social services.
The transfer faced legal challenges, with the plaintiffs arguing that PhilHealth’s funds, taken from member contributions and specific taxes, should be exclusively used for health-related purposes, as mandated by the UHCA.
In the same hearing, Justice Ricardo R. Rosario asked Finance Secretary Ralph G. Recto what would be the outcome if the high court ordered the return of the funds to PhilHealth and the P100 billion, fully transferred from the Philippine Deposit Insurance Corporation (PDIC) to national coffers.
Mr. Recto said: “If the government were to tell the executive to return the money, we will include that in the National Expenditure Program for 2026.”
“Assuming if the ruling works for 2025, that will add a fiscal pressure to our deficit and that would entail us not hitting our deficit targets this year,” Mr. Recto added. “And if we miss that, then we may not attain our coveted credit rating upgrade that we foresee in the next 18 months.” — Chloe Mari A. Hufana
