SC urged to issue TRO ahead of PhilHealth case oral arguments

In Senate, limited coverage of hospital billings hit

SC urged to issue TRO ahead of PhilHealth case oral arguments

By: - Reporter /
/ 05:36 AM October 10, 2024

SC urged to issue TRO ahead of PhilHealth case oral arguments

Atty. Neri Colmenares, former Bayan Muna Partylist representative. —Joseph Vidal/ Senate PRIB

MANILA, Philippines — Former Bayan Muna Rep. Neri Colmenares on Wednesday appealed anew to the Supreme Court to issue a temporary restraining order (TRO) on the transfer of Philippine Health Insurance Corp. (PhilHealth) funds to the national treasury to cover unprogrammed appropriations.

The high court held a preliminary conference regarding two consolidated petitions challenging the fund transfer to sort out issues ahead of the oral arguments scheduled on Jan. 14, 2025.

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“While we submit to the Supreme Court’s decision to hold the oral arguments in 2025, we wish to reiterate the request for a temporary restraining order on the transfer of PhilHealth funds to unprogrammed funds, as this would render the issue moot,” Colmenares said in a statement following the conference.

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“We ask the Court to restrain this as there is nothing urgent about the projects in the unprogrammed funds. That’s why Congress placed these projects there—because they consider them less urgent than the programmed funds,” he pointed out.

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In a petition filed on Aug. 2, Sen. Aquilino Pimentel III, along with doctors and public health advocates, asked the high tribunal to halt the transfer of P89.9 billion from PhilHealth to fund other government projects, arguing that the move was illegal and unconstitutional.

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Too late

The case was docketed as G.R. No. 274778 and later consolidated with G.R. No. 275405, which involved the petition filed on Sept. 6 by the group led by Colmenares.

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In their petition filed on Sept. 6, Bayan Muna sought to nullify the presidential certification of urgency for House Bill No. 8980, or the general appropriations bill, citing that no existing calamity or emergency as required under the Constitution was present.

On Oct. 16, the Bureau of the Treasury is set to receive P30 billion from PhilHealth, the third tranche of the P89.9 billion in “excess” funds covered by the transfer.

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The final transfer of the remaining P30 billion is scheduled for November.

Although the Supreme Court set the oral arguments for early next year, the full P89.9 billion will likely have been remitted by then, raising concerns about the case’s mootness.

In an advisory issued on Sept. 25, the Supreme Court outlined key issues for the orderly conduct of the oral arguments on Jan. 14.

As a preliminary issue, the court will consider whether a TRO or status quo ante order should be issued to halt the fund transfers.

Among the substantive issues is the validity of a special provision in the 2024 national budget that allows using funds from government-owned or -controlled corporations for specific purposes.

Very little coverage

In Congress, Sen. JV Ejercito on Wednesday called for the immediate replacement of PhilHealth leadership due to the apparently poor implementation of the universal health care (UHC) law.

“PhilHealth’s head needs to be replaced for failure to live up to the purpose of the UHC law, being the primary agency tasked with its implementation,” Ejercito said.

The principal sponsor of the UHC law said the agency had not delivered on its mandate, leaving many Filipinos struggling with health-care costs.

“This issue is very close to my heart. The budget for the Department of Health (DOH) and PhilHealth is crucial, especially since we are now entering the fifth year of the UHC law’s implementation. It’s a 10-year program, and by now, the benefits should be felt by most Filipinos,” Ejercito noted.

“Although we’ve seen some improvements—such as reducing out-of-pocket expenses from 70 percent to 42 to 45 percent—there is still a long way to go. We should be targeting zero-balance billing for indigents, senior citizens, PWDs (persons with disabilities), and other vulnerable groups,” he added.

The senator expressed disappointment over PhilHealth’s limited coverage in hospital billing, citing instances where bills reach hundreds of thousands of pesos yet PhilHealth only covered a fraction.

Ejercito presented to the media copies of actual hospital bills from private and public hospitals, in which only small portions of the patients’ total bills were covered by PhilHealth.

One of the hospital bills he presented reached more than P1.5 million, but only P10,700, or 0.69 percent, was deducted or covered by the state health insurer. Another hospital bill amounting to over P430,000 had only P20,000 PhilHealth coverage.

Higher benefits

Hounded by such criticism, PhilHealth said it will further increase almost all of its benefit packages by up to 50 percent before the end of the year.

PhilHealth president and CEO Emmanuel Ledesma Jr. said the state-run health insurer plans to implement another “30-percent to 50-percent increase” in benefit coverage by November across all its benefit packages.

On top of the 30-percent increase implemented in February as an adjustment for inflation, PhilHealth will be implementing a 60-percent to 80-percent increase in almost all of its around 9,000 case rates before the end of the year.

“For the past 10 years, PhilHealth’s benefit packages have not been increased. So now, we have to catch up,” Ledesma said at a press briefing in Quezon City early this week. “I don’t know when we’ll be able to reach a 100-percent increase across the board of case rates, but all I can say is we are already moving as fast as we can.“

Expanded coverage for severe dengue, ischemic heart disease, myocardial infarction, and cataracts is to be implemented before the end of this year.

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By early 2025, Ledesma said PhilHealth will also expand their support to patients with lung, liver, ovary, and prostate cancers by improving our coverage for chemotherapy. —with reports from Tina G. Santos and Dexter Cabalza

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