Mr Speaker, I beg to move, that this Honourable House adopts the Report of the Committee of the Whole on the Proposed Formula for the Disburse- ment of the National Health Insurance Fund for the year 2019.
Mr Speaker, in so doing, I would present your Committee's Report.
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Introduction
On Friday, 22nd March, 2019, the Proposed Formula for the Disburse- ment of the National Health Insurance Fund for 2019 was presented to Parliament. The Formula was referred to the Committee of the Whole for consideration and report in accordance with the Standing Orders of the House and article 103 (3) of the 1992 Constitution of the Republic of Ghana.
Reference Documents
The Committee, during its delibera- tions, referred to the following document:
i. The 1992 Constitution of the Republic of Ghana;
ii. The Standing Orders of the House;
iii. The National Health Insu- rance Act 2012 (Act 852) as amended by the National
Health Insurance (Amend- ment) Act, 2015 (Act 888)
iv. The Formula for the Disbur- sement of the National Health Insurance Fund for 2018; and
v. The Report of the Committee of the Whole on the Formula for the Disbursement of the National Health Insurance Fund for the year 2018.
Acknowledgement
In attendance at the Committee's deliberations were Hon Kingsley Aboagye-Gyadu, Deputy Minister for Health, Dr Lydia Dsane-Selby, Acting Chief Executive Officer of National Health Insurance Authority (NHIA), Mr Ahmed Imoro, Director of Finance, NHIA. The Committee is grateful to them for their assistance.
Background
The Government of Ghana, through the Ghana Poverty Reduction Strategy (GPRS), planned its policy strategies of the essential components of the GPRS. One of the strategies was aimed at delivering accessible and affordable healthcare to all residents in Ghana, especially the poor and vulnerable. In achieving the objective of “universal health care, the National Health Insurance Scheme (NHIS) was established by the enactment of the National Health Insurance Act, 2003 (Act 650) to provide financial risk protection against the cost of quality basic healthcare for all
residents in Ghana. The NHIS introduced the district-wide mutual health insurance scheme to enable access to basic healthcare services without paying cash at the point of delivery. The National Health Insurance Act, 2003 (Act 650) was later repealed and replaced by the National Health Insurance Act, 2012 (Act 852).
The enactment of Act 852 brought the National Health Insurance Authority (NHIA) into being to secure the implementation of a National Health Insurance Policy. The law, Act 852, also established the National Health Insurance Fund (NHIF) under section 39, and mandates the Council of NHIA to take charge of the responsibility of the management of the Fund. The National Health Insurance Act, 2012 (Act 852) was also later amended by the enactment of the National Health Insurance Act, 2015 (Act 888) to limit the scope of exemptions in respect of exempt supplies.
Object of the Fund
The object of the Fund is to pay for healthcare services of members of the National Health Insurance Scheme (NHIS).
For the purposes of implementing the object of the Fund, section 40 (2) of Act 852 stipulates that moneys from the Fund shall be expended as follows:
i. To pay for the health care costs of members of the National Health Insurance Scheme.
ii. To pay for approved admini- strative expenses in relation to the running of the National Health Insurance Scheme.
iii. To facilitate the provision of access to healthcare services.
iv. To undertake investments to promote access to health services as may be deter-mined by the Minister for Health in consultation with the Board of the Authority.
Sources of the Fund
The sources of the Fund, as stipulated in section 41 of Act 852 are as follows:
i. The National Health Insu- rance Levy (NHIL);
ii. Two and a one half per cent (2.5 per cent) of each person's contribution to the Basic SSNIT Pension Fund;
iii. Moneys approved for the Fund by Parliament;
iv. Moneys that accrue to the Fund from investments made by the Authority;
v. Grants, donations, gifts and any other voluntary contribu- tions made to the Fund;
vi. Fees charged by the Authority in the performance of its functions;
vii. Contributions made by members of the Scheme, and
viii. Moneys accruing from the National Insurance Commis- sion under section 198 of the Insurance Act, 2006 (Act
724)
Receipts And Payments For 2018
In respect of NHIL, the Authority received an amount of GH¢1,473.28 billion from the Ministry of Finance for the year ended 31st December, 2018. Premium amounted to GH¢53.52 million, Processing Fee Income, GH¢49.72 million, invest- ments, GH¢28.82 million and Donor Receipts and Other Income, GH¢14.19 million during the period, bringing total receipts to GH¢1,619.53 billion (amount available on cash basis at the close of 2018).
Payments made during the period amounted to GH¢1,585.380,000 billion and it included claims payment of GH¢1,047,700,000 billion which translates into 66.1 per cent. Excess receipts over payments therefore stood at GH¢34.15 million (operational surplus on cash basis). Details are in Appendix A attached to the Report.
Revenue and Expenditure for
2018
On accrual basis, the total budget expenditure for the year ending 31st December, 2018, was GH¢1,732.66 billion as against an annual budget of
GH¢2,375,240,000 billion, resulting in a difference of GH¢642.58 million. Details are in Appendix B attached.
Comparative Analysis of NHIL/ SSNIT Collections and Receipts
The Authority's Budget allocation from NHIL/SSNIT for 2018 was GH¢2,233.920,000 billion as contained in the Budget Statement and Economic Policy for the 2018 Financial Year. However, NHIL/ SSNIT collections for the year (including estimated NHIL collections for December 2018 and SSNIT collections from October to December 2018) was GH¢1,579,490,000 billion. Of the total collections, an amount of GH¢506.80 million constituting 32.1 per cent had been received by the Authority as at 31st December, 2018.
