RA11223: AN ACT INSTITUTING UNIVERSAL HEALTH CARE FOR ALL FILIPINOS, PRESCRIBING REFORMS IN THE HEALTH CARE SYSTEM, AND APPROPRIATING FUNDS THEREFOR
Republic Act No. 11223, known as the "Universal Health Care Act," guarantees automatic inclusion of every Filipino citizen into the National Health Insurance Program (NHIP), ensuring access to comprehensive health services without financial hardship. This includes preventive, promotive, curative, rehabilitative, and palliative care for medical, dental, mental, and emergency health needs.
Within two years, PhilHealth is mandated to implement a comprehensive outpatient benefit, including drug benefits and emergency medical services. The Department of Health (DOH) and local government units (LGUs) are tasked with establishing a healthcare delivery system where every Filipino can register with a primary care provider of their choice. Population-based health services will be financed by the National Government through the DOH and provided free of charge.
The Act outlines funding sources, including incremental sin tax collections, 50% of the National Government's share from PAGCOR, and 40% of the PCSO's Charity Fund, in addition to member contributions and annual government subsidies to PhilHealth. Importantly, failure to pay premiums will not prevent members from enjoying Program benefits, though employers and self-employed direct contributors will be required to pay missed contributions with interest.
The law also includes penal provisions for violations by healthcare providers, members, and employers, ranging from fines and suspension of benefits to imprisonment for fraudulent acts. The DOH is also tasked with strengthening health promotion efforts and establishing a Health Promotion Bureau to improve health literacy.