PhilHealth chief reassures financial stability amid challenges

By Wilnard Bacelonia, Philippine News Agency

Ledesma assured the panel that PhilHealth remains fully capable of meeting its obligations without disruption to members’ benefits. (PNA file photo by Ben Briones)

MANILA – The Philippine Health Insurance Corporation (PhilHealth) on Thursday allayed anew various concerns regarding its financial stability and commitment to universal health coverage.

During the Senate Committee on Health and Demography hearing, PhilHealth President and Chief Executive Officer Emmanuel Ledesma Jr. emphasized the agency’s sound financial footing despite challenges stemming from zero subsidy allocation in the 2025 General Appropriations Act and the Department of Finance’s directive to transfer PHP30 billion in unutilized funds to the National Treasury.

Ledesma assured the panel that PhilHealth remains fully capable of meeting its obligations without disruption to members’ benefits.

“Our reserve funds are adequate due to prudent financial management, and all programs are being implemented as usual. No benefit packages will be reduced or removed this year,” he said, noting that the state insurer still has PHP29.9 billion in reserve funds.

Ledesma also highlighted significant improvements in PhilHealth benefit packages last year, including a 95 percent increase in the all-case rate coverage.

He said new benefit packages have been introduced, and existing ones have been expanded.

These include breast cancer treatment coverage increased by 1,300 percent; hemodialysis package increased by 144 percent; substantial coverage increases in cardiovascular diseases like heart attack, stroke, and ischemic heart disease; kidney transplantation (Z benefit package) coverage expanded to include procedures for living and deceased donors, with funding of up to PHP2.15 million; Z benefit package now includes 10 rare conditions, including Maple Syrup Urine Disease and Osteogenesis Imperfecta.

Preventive health measures were also enhanced, with oral health services included in the Konsulta program, providing dental care for members, including children aged 0 to 15.

“This year, we aim to intensify efforts to improve efficiency and reduce administrative costs to ensure that every peso contributes to better health outcomes,” he said.

While acknowledging challenges, Ledesma expressed confidence in PhilHealth’s ability to sustain its role as the national health insurer and contribute to the broader goal of universal health coverage.

“PhilHealth is facing a pivotal moment, but I assure our members that we are equipped to overcome these challenges and continue fulfilling our mandate,” he said.

“We can assure each and every member of PhilHealth, huwag po kayong mangamba. Huwag po kayong matakot pumunta sa ospital at sa doktor, sagot po kayo ng PhilHealth (do not hesitate. Do not be afraid of going to the hospital and the doctor, PhilHealth has you covered), rest assured,” he added.

Starting Jan. 1, PhilHealth has increased the case rates of 9,000 packages by 50 percent.

Ledesma has earlier assured members that the new and expanded benefit packages will not result in a premium hike this year or in the coming years.