House Assistant Majority Leader and Lanao del Sur Rep. Zia Alonto Adiong insisted Tuesday that the Philippine Health Insurance Corp. (PhilHealth) has more than enough reserve funds to cover the health needs of Filipinos, contrary to false claims circulating in social media.
“The circulating message that ‘getting sick is prohibited next year’ because PhilHealth has no funds because it was not granted premium subsidy in its 2025 budget is fake news,” Adiong said.
During recent congressional hearings, lawmakers learned that PhilHealth’s investible funds has reached P504-billion.
On top of this, Adiong said PhilHealth officials reported that its surplus reserve funds amounted to P183-billion apart from two unutilized Special Allotment Release Orders (SAROs) amounting to P42 billion.
“Thus, it’s clear that the State health insurer has more than enough to cover the health needs of Filipinos even for the next two years,” Adiong stressed.
The substantial reserve exceeds the statutory requirement, which mandates that PhilHealth maintain a reserve fund equivalent to two years’ worth of average benefit payments.
The Department of Finance (DOF) estimates this requirement at P280 billion, or P140 billion per year. PhilHealth’s current reserves significantly surpass this threshold, underscoring its financial stability, Adiong said.
“Note, too, that even with zero premium subsidies from the government, annual premium collections from direct members are sufficient to cover average benefit spending of P140-billion,” Adiong said.
“Ultimately, the question is: why does PhilHealth have over P500-billion in investments, when its primary mandate is to spend to save the lives and pockets of our kababayans, not to earn interest?” he asked.
In the proposed 2025 national budget, the bicameral conference committee allocated zero funding for PhilHealth subsidies. This decision was based on PhilHealth’s ample reserves and investible funds, which are deemed sufficient to cover its obligations without additional government support.
In fact, Adiong said that upon orders from the DOF early this year, the State insurer returned unused reserve funds to the national treasury, further proof that it really has excess funds. Additional transfers, however, were halted by a Supreme Court (SC) temporary restraining order.
Under the Universal Health Care Act, when PhilHealth possesses excess funds, it has the authority to either expand benefits or reduce premium contributions.
While there have been calls from Congress to implement both measures, he said PhilHealth has initiated benefit increases, such as enhancing the hemodialysis benefit package.
However, Adiong said the expansion of other benefits, particularly in primary care services like the Konsulta package, has been gradual despite additional budgetary support of P42-billion in the last two years.
Given these resources, Adiong said the circulating warnings about PhilHealth’s financial incapacity are baseless.
“We should not get fooled. PhilHealth’s substantial reserves and ongoing benefit enhancements ensure that Filipinos will continue to receive the healthcare support they need in the coming years,” he stressed.
