This archive report was first published on 6 October 2021.
Published on October 6, 2021, a draft report on Kenya's comprehensive medical sector revealed a concerning trend: only 20% of Kenyans have any form of health insurance.
The report, developed by i3 Actuaries and Consulting team, highlights the need for increased penetration of public health insurers and overall Universal Health Coverage (UHC). To achieve this, the report proposes changes to the current health insurance regulatory framework.
Key recommendations include bringing community-based health within the regulatory scope of the Insurance Regulatory Authority (IRA) and licensing Health Maintenance Organisations as a new license category. Additionally, the report suggests that all policyholders should have access to the same policy options and be included in the same risk pool.
"There should be provision for regular review and amendment to the prescribed minimum benefits (PMB) package to adjust for changes in affordability and the overall disease burden," the proposal document states.
Other proposals include giving the IRA the power to enforce corrective measures on market players who set unreasonably low premiums and requiring insurers to file marketing material for approval.
