President William Ruto’s ambitious social health insurance plan has encountered significant obstacles, with a Senate committee recommending the annulment of the regulations meant to operationalize the plan. This follows a recent High Court ruling that declared the supporting laws unconstitutional.
The Senate Select Committee on Delegated Legislation, led by Chairman Mwenda Gataya, found several constitutional inconsistencies in the regulations. The Ministry of Health failed to demonstrate adequate public participation and engagement with the Council of Governors (CoG), a crucial requirement for the regulations’ legitimacy.
“The Committee could not ascertain and verify from documentary responses submitted by the Ministry the extent to which the input from the counties through the CoG’s submissions during public participation and other stakeholders’ engagement was considered and incorporated into the final regulations,” the committee noted.
Additionally, the Ministry did not provide a clear financial assessment of the regulations’ impact on the public, nor did it outline the transition from the current National Health Insurance Fund (NHIF) to the new framework. This lack of clarity raised concerns about the feasibility and inclusiveness of the plan, especially in addressing the needs of vulnerable families.
Makueni Senator Dan Maanzo emphasized the importance of county involvement, given the devolved nature of healthcare under the constitution. “If the counties are not properly consulted and they are not even aware of the publication of the regulations, it becomes very difficult,” he said.
The High Court had already suspended the implementation of the Social Health Insurance Act for 120 days to allow Parliament to make necessary amendments. Justices Alfred Mabeya, Robert Limo, and Fridah Mugambi identified constitutional breaches in sections 26(5) and 27(4) of the Act, which imposed mandatory registration and contributions as preconditions for accessing public services and healthcare.
Originally slated for a July 1 rollout, the health plan was postponed to October. However, this timeline is now uncertain due to the legal and legislative hurdles.