Recto gains ally in push for better PhilHealth benefits for contributors

MANILA, Philippines — Executive Secretary Ralph Recto’s proposal of a greater benefits package for people who contribute to the Philippine Health Insurance Corporation (PhilHealth) fund got an ally in former Eastern Samar governor Ben Evardone, saying that it has a basis in law.

Evardone in a statement on Friday said that this proposal from Recto should be implemented because it will help people who pay premiums to PhilHealth get better health services, adding that Republic Act No. 11223 or the Universal Health Care (UHC) Act has a provision that allows it.

The former governor, who also served as a congressman, was referring to Section 9 of R.A. No. 11223 which states that PhilHealth “shall provide additional program benefits for direct contributors, where applicable.”

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“The Universal Health Care Law (Republic Act No. 11223) allows it.  The law mandates Philhealth to grant more benefits to its direct contributors, who comprise 63.4 percent or majority of the state health insurer’s 58.7 million members (as of 2025),” he said.

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“Philhealth should now obey the law and do justice to its millions of paying members and their dependents,” he added.

Last June 21, Recto broached the idea of paying members of the PhilHealth getting benefits commensurate with their monthly contributions — which means providing better packages for contributors.

Recto made the proposal following the death of a 47-year-old father from Manila, who had been diligently paying his monthly premiums for more than two decades but was denied PhilHealth benefit packages.

READ: Recto pushes for more PhilHealth benefits for paying members

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The Executive Secretary said he would meet with PhilHealth officials this week to discuss the expansion of benefits for more than 33 million paying members.

“Under the law, they have a different benefit package. Let’s increase it,” he said in a radio interview.

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However, several health professionals opposed this proposal from Recto, saying that such a move may lead to a polarization between direct and indirect contributors.

READ: Groups reject PhilHealth scheme pushed by Recto

In an open letter to Recto, the groups said this move may lead to unequal PhilHealth benefits based on contributions — more for direct contributors, and less for indirect contributors, or those paid for by the government.

“We understand that many working Filipinos feel they are not receiving enough benefits in return for the premiums they pay. This is not because indigent patients receive too much, or to use your own words, ‘panalo sila’ (they are winners),” the medical groups said.

“This is because the government is failing to shoulder its lawful share in financing the premiums of the poor. As a result, direct contributors end up paying for a larger share of the country’s healthcare than the law intended,” they said.

Former COVID-19 national task force special advisor Dr. Tony Leachon said that Recto’s proposal goes against R.A. No. 11223, as the law mandates “equal coverage for all Filipinos.”

“Every Filipino citizen must be covered — not just the middle class, who are already the ‘new poor’…The poor are getting poorer, while the rich gain an advantage under a two-tiered benefits system,” Leachon added.

READ: Leachon: PhilHealth benefit expansion for paying members betrays UHC law

Evardone said that he understands the concerns about unequal benefits, noting that the indirect contributors can get better packages through an increase in the government’s subsidy for PhilHealth — or the allocation that PhilHealth gets under the annual General Appropriations Act.

“The remedy is not to continue withholding or denying what is due paying members but to look for additional funds for their non-contributory counterparts,” he said.

Aside from the better benefits package for paying contributors, Evardone urged for the implementation of another proposal from Recto — higher PhilHealth coverage for services in hospitals owned by local government units (LGUs).

Evardone said this is needed to ensure that LGUs would not spend most of its funds for healthcare only.

“Hospital services are draining so much funds of LGUs, which, as we all know, have to fund various programs, projects and activities, including infrastructure, education and helping poor residents,” he said.

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“They need as much help as they can get from PhilHealth for the healthcare of their constituents,” he added. /jpv