SHA responds to TSC allegations on Teachers’ Medical Cover

After disclosing that every instructor throughout the nation was locked out, the TSC received a response from the SHA.

In response to assertions by the Teachers Service Commission (TSC) that it refused to register more than 360,000 instructors because it lacked a national infrastructure, the Social Health Authority (SHA) has responded.

After teachers were informed that the Authority lacked the necessary infrastructure nationwide to support them, attempts to integrate them into the SHA program failed, according to TSC CEO Nancy Macharia, who testified before the National Assembly Education Committee.

She also stated that, despite TSC’s long-standing desire to include instructors in a public insurance plan, this has not been feasible to date.

“We have always wanted to have our teachers under the national insurer, even during the NHIF days,” she stated. “Last year, when we had issues with Minet, we wanted to move our teachers to SHA.”

According to SHA, however, all teachers and their dependents are covered by the Social Health Authority’s (SHA) benefits package under the three Funds.

Like all other Kenyans who are registered and contributing, these include the Primary Healthcare Fund (PHC), Social Health Insurance Fund (SHIF), and Emergency, Critical & Chronic Illness Fund (ECCIF).

The authority stated that employers like TSC can offer their employees supplementary insurance for extra benefits via a reputable insurance underwriter.

SHA stressed that this additional coverage is administered independently of the services it offers.

“The Social Health Authority does not administer the TSC free medical coverage that they obtained from a commercial insurance company,” the statement read in part.

However, SHA said that TSC can enroll its members in the public officers’ medical plan fund, where the complimentary benefits will be decided according to the budget.

According to Macharia, the authority reported a Ksh17 billion deficit.
The National Assembly Education Committee was informed by Nancy Macharia on that day that the government had set aside Ksh20 billion for the medical plan, but SHA maintained that Ksh37 billion was necessary to cover the teachers.

“Before extending our contract with Minet for this last year, we met with SHA, and they informed us that they lacked sufficient buildings. They told the committee that they would need Ksh.37 billion to enroll our teachers, but that even then, they were not prepared to accept them this year.

The alarming story of a teacher who, despite having insurance, was put in solitary confinement for three months for not paying a hospital bill was told by Committee Chairperson Julius Melly.

“What sort of insurance coverage is this? It’s a hybrid; it has no head or tail. It’s a really strange kind of insurance since you have an insurer, a lead consortium, an administrator, and a capitator. You have to get out of here, Melly urged.

Minet Insurance and TSC signed a three-year extension in December 2022 that will expire in November 2025.

But the Minet-run program is still under fire for its subpar service delivery, inefficiencies, and delays.

The SHA claims that 21.6 million Kenyans have signed up for the SHA, with an average of 50,000 new registrations every day.