The Philippine Health Insurance Corporation (PhilHealth) is in a financially sound position, according to its President and CEO, Emmanuel Ledesma Jr., who shared this during a recent session with lawmakers. Despite areas requiring attention, Ledesma emphasized that PhilHealth’s financial status is robust, supported by substantial reserves and a significant surplus.
In the proposed 2025 national budget, the bicameral conference committee decided against allocating any subsidies to PhilHealth, citing the corporation’s ample reserves and investible funds. As of October 2024, PhilHealth reported a surplus of PHP150 billion and total reserves amounting to PHP280 billion. Additionally, by November 2024, the corporation’s investment fund was nearing PHP490 billion.
Ledesma highlighted that these figures underscore PhilHealth’s financial strength, enabling it to sustain operations and meet the healthcare needs of its 115 million members. He announced plans to increase coverage for most case rate packages by 50 percent, aiming for an overall increase of 80 percent by year’s end. These adjustments are intended to ensure fair compensation for expensive treatments and alleviate financial pressures on patients and healthcare providers.
Despite its financial health, PhilHealth has faced challenges, including leadership instability and issues with public trust. Ledesma acknowledged past shortcomings, particularly during the previous administration, which saw frequent CEO changes and delayed reforms. To address these issues, he outlined initiatives focused on strengthening governance, improving benefit delivery, and embracing digitalization to enhance efficiency and reduce fraud.
Ledesma assured that PhilHealth would continue to expand benefits without relying on national government subsidies. He emphasized that the corporation’s financial stability allows it to fulfill its obligations and provide benefits to all members, including the most vulnerable. House Assistant Majority Leader, Lanao del Sur Rep. Zia Alonto Adiong, supported this, stating that PhilHealth has sufficient funds to meet Filipinos’ health needs for the next two years, refuting claims of resource scarcity.
PhilHealth’s reserves exceed the statutory requirement of maintaining a reserve fund equivalent to two years’ worth of average benefit payments, estimated at PHP280 billion by the Department of Finance. This surplus underscores the corporation’s financial stability and its ability to operate without government subsidies, as annual premium collections from direct members are sufficient to cover average benefit spending.