Governors have called for an urgent review of the Social Health Authority (SHA) and insurance laws to correct clauses they term punitive, unrealistic, and discriminatory to county governments.
Speaking during an induction meeting for newly appointed members of the Council of Governors (CoG) Health Committee, county chiefs raised concerns that the current framework undermines devolved health functions and exposes counties to penalties for circumstances beyond their control.
Among the clauses flagged is the requirement that counties remit statutory deductions to the Social Health Authority by the 9th of every month, failure to which they face penalties.
Governors argue this provision is unfair since the national government often delays disbursement of funds from the Exchequer.
“It is unfair to punish counties for late remittances when the national government has not released funds. We cannot pay what we don’t have,” said Tharaka Nithi Governor Muthomi Njuki, who serves as the CoG Whip.
“There should be flexibility in the timelines to account for Exchequer delays.”
According to the law, the National Treasury is required to disburse county allocations by the 15th of every month, but governors said this rarely happens.
They noted that delays have left counties struggling to meet their obligations, sometimes resorting to bank overdrafts.
The Chairperson of the Health Committee, Mombasa Governor Abdulswamad Shariff Nassir, said the council would be proposing specific amendments in the coming days to address the gaps observed during the initial implementation of the new social health system.
“We have identified clauses that need to be revisited. The Council will be presenting proposals to make the law more practical and responsive to county realities,” said Nassir.
Governors also took issue with the planned rollout of ambulatory services, likening the proposed model to digital taxi operations.
They warned that without clear coordination, the move could render existing county-owned ambulances obsolete.
“We must be part of the process of vetting and standardizing ambulances that will operate in our regions,” said Mandera Governor Mohammed Khalif.
“Counties already have ambulances, and any parallel system must complement, not compete with, them.”
Another concern raised by the governors is the deterioration of services at Level 2 facilities, where expectant mothers are reportedly unable to access essential maternal health services.
“We are getting worrying reports that some mothers are dying in these facilities, and others can no longer give birth at Level 2 hospitals as provided,” said Baringo Governor Benjamin Cheboi.
“This deprives counties and citizens of over KSh 2.6 billion meant for maternal health.”
CoG CEO Mary Mwiti emphasized that the council will continue engaging both the Ministry of Health and the National Treasury to ensure equitable health financing and a balanced rollout of the new insurance framework.
“Counties cannot continue carrying the burden of national policy gaps. We must have an inclusive approach,” Mwiti said.
The governors want the proposed changes finalized before December 10, ahead of a scheduled Summit meeting with President William Ruto, where they plan to push for adjustments in the implementation timelines and funding structures.
Council Health Director Khatra Ali echoed the need for collaboration between both levels of government, noting that donor withdrawal from the health sector has worsened the resource strain.
“We must rethink health financing comprehensively. With many donors pulling out, the two levels of government must find a sustainable model,” she said.
