How the Social Health Authority, SHA, will be implemented

The Ministry of Health has explained how it will roll out the Social Health Authority despite the court cases against its implementation.
On July 12, the High Court declared all three laws that will support SHA as “null and void” for lack of public participation, and some sections being unconstitutional.

The court suspended its decision for 45 days after the Attorney-General’s office argued that the ban would leave a void in the health sector.
The court also gave MPs 120 days to amend the sections that it deemed unconstitutional.
The Ministry of Health is currently registering new members.

Medical Services PS Harry Kimtai said the ministry is still within the 45 days given by the court.

He said SHA would be launched next month as planned because the court gave the government several pathways.

“After the Acts were declared unconstitutional, we filed an appeal at the Court of the Appeal. We asked for a stay order until our case is heard and determined. The ruling will be made on September 20,” the PS said at a media briefing in Nairobi on Wednesday.

“If our prayer is allowed, we will continue to implement SHA until the case is heard and determined. If we are not granted the stay order, we will go back to the 120 days we were given for MPs to amend the Acts,” he said.
The 120 days lapse on November 20.

Justices Alfred Mabeya, Robert Limo, and Fridah Mugambi, on July 12 declared three laws that underpin the new authority null and void.
They then gave lawmakers a window to amend the legislation.

“This should be done within 120 days. If they fail to, the Act shall remain suspended. A declaration is issued that the entire Social Health Insurance Fund Act 2023, the entire Digital Health Act 2023 and the entire Primary Health Act 2023 are all unconstitutional for the reasons set out in this judgement and therefore invalid; null and void,” they said in their ruling.
However, the judges later suspended their ruling temporarily for 45 days.

They said the suspension would not apply to Sections 26(5) and 27(4) of the fourth law, the Social Health Insurance Act (SHIA), which were declared unconstitutional.

Section 26(5) denies public services to Kenyans not registered with SHA or whose contributions are not updated. Section 27(4) states a person shall only access healthcare services if their contributions are up to-date and active.

Kenyans are required to pay 2.75 per cent of their gross income, from the end of October. The September salaries, paid to employees at the end of this month or early October, will be taxed under the old NHIF rates.

“Contributions for Salaries for September will be paid to NHIF because anyone going to hospital up to September 30 will access NHIF benefits,” the PS said, noting that employers have already been notified.

Kimtai said at least 1.2 million Kenyans have registered for SHA, the authority that will replace the National Health Insurance Fund (NHIF).

“The daily rate of registration is about 60,000 Kenyans. We expect this to go up by the end of September,” he said.

Dr Daniel Mwai, a presidential advisor on health, said the 1.2 million represent households, each of about four people. “This means we have about 4.6 million registered,” he said.

The ministry also announced all NHIF staff have been absorbed by SHA and nobody will be laid off.

Public Health PS Mary Muthoni said the community health promoters (CHPs) work is ongoing and they have so far screened 5.8 million Kenyans for diabetes.

“Among them, 106,000 have been referred to health facilities. Also, four million people have been screened for high blood pressure and 270,000 have been referred to health facilities.