January 15, 2025 | 4:52pm
MANILA, Philippines — The Philippine Health Insurance Corp. (PhilHealth) can access up to P759 billion to cover benefit expenses, a House lawmaker pointed out.
During a House Committee on Health hearing on Wednesday, January 15, discussions focused on PhilHealth’s plans to expand benefit packages and adjust case rates.
Rep. Stella Quimbo (Marikina, 2nd District) asked the Department of Budget and Management (DBM) to break down the state insurer’s potential funding sources.
According to the DBM, PhilHealth could tap the following funds, including its corporate operating budget, to increase its benefit packages or pay for benefit claims:
- P150 billion in surplus reserve funds
- P203 billion in estimated premium collection for 2025
- P80 billion in unfunded allotment of 2023 and 2024
- P21 billion in unreleased appropriations
In total, this already amounts to P454 billion. DBM Director III Lulu Vispo told the committee that PhilHealth only needs to request fund releases through a special budget request.
Quimbo further sought clarification if PhilHealth’s reserve fund could be used as well.
“Legally speaking, yung P280B na reserves, hindi ba talaga absolutely pwedeng gamitin yan? (Can’t you really use that?)” she asked.
PhilHealth Senior Vice President Renato Limsiaco clarified that the agency has P280 billion in reserve funds, as mandated by law to ensure a two-year buffer.
While these are often set aside and left untouched, he said it could be utilized when needed.
“Ang purpose naman ng reserve (The purpose of the reserve) is just in case you underestimated or you overestimated your expenses, you can actually dip into your P280 billion,” Quimbo said, to which Limsiaco agreed.
What about the investment income? DBM confirmed it as a valid funding source, provided that the state insurer submits the necessary documents.
Limsiaco said PhilHealth earned P25 billion in investment income in 2024. Adding this to the other sources, the accessible amount rises to P479 billion.
Including the reserve fund for extreme scenarios, PhilHealth’s total potential funding reaches P759 billion, Quimbo calculated.
Since DBM and PhilHealth confirmed that the P280 billion reserve fund could also be used, in case of emergencies, the total possible amount is around P759 billion.
“Hindi naman syempre uubusin ang P280 [billion], kasi ang sinasabi ko lang sa extreme scenario (Of course, the P280 billion won’t be completely used up, because I’m just pertaining to an extreme scenario),” Quimbo clarified. “That’s the full range of possibilities for 2025.”
Asked about PhilHealth’s total cash on hand as of Dec. 31, 2024, Limsiaco said it was at P492 billion. This excludes the uncollected premium contributions of P203 billion from direct contributors and the nearly P100 billion available funds from DBM.
“So at least, that’s the entire picture. But the bottom line is: we really have more than enough to fund your corporate budget of P280 billion,” Quimbo said, stressing PhilHealth’s mandate to boost benefit packages and lower contribution rates.
RELATED: PhilHealth to run on P284 billion budget in 2025, even without gov’t subsidy
In 2025, PhilHealth will operate without government subsidies, relying instead on its substantial reserve fund and its corporate operating budget of P284 billion, primarily funded through premium contributions.
The state insurer has been increasing case rates, allowing Filipinos to claim higher reimbursements for medical treatments or procedures.
However, lawmakers worry these adjustments merely account for inflation, given that benefit package improvements were only introduced in recent years and hospital fees have surged since.
The thousands of denied and returned hospital claims — payable amounts that PhilHealth still owes — remain a separate issue altogether.
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