In a move that has taken many by surprise, the government has officially suspended the use of the National Hospital Insurance Fund (NHIF) at all healthcare facilities across the country, effective February 1, 2025.
This unexpected decision comes at a time when many Kenyans are already grappling with the recent rollout of the new State Health and Accident Insurance (SHAH), launched last year as a government-backed initiative to replace the NHIF.
The government’s decision to suspend NHIF, a crucial pillar of Kenya’s public healthcare system, has left thousands of patients in limbo.
Hospitals across the country are reporting an overwhelming number of individuals turned away, unable to access the healthcare they desperately need.
Meanwhile, the SHAH scheme, touted as a comprehensive replacement, has come under fire for its apparent failure to function as intended.
Since Friday, February 1,2025 when the suspension was imposed, hospitals nationwide have reported widespread confusion, with patients unable to access care using NHIF, and the SHAH system proving unreliable.
Medical institutions were left scrambling to find alternative payment options, but with limited success.
This has resulted in an escalating crisis, with patients who had hoped to use their NHIF coverage now forced to pay out of pocket or forgo treatment altogether.
This leaves citizens caught in an alarming healthcare limbo, raising serious questions about the government’s ability to provide a stable, functioning health insurance system.
Our team visited several prominent city hospitals in Nairobi, and witnessed firsthand the turmoil caused by the suspension.
In each case, patients were turned away, unable to pay for services as they had expected to use NHIF coverage.
At one leading city hospital, patients were seen arguing with hospital staff as they were turned away from the emergency and outpatient departments.
Most had been advised to seek other means of payment or wait until the issues were resolved.
For many, this meant a frightening wait for treatment, often with no certainty of when they could access the care they needed.
“It’s chaotic,” one hospital staff member admitted.
“People are angry and frustrated because they can’t get treatment, and we have no answers to give them. The new SHAH system is not working either.”
While SHAH was introduced last year with the promise of better healthcare coverage for all, it has already faced significant hurdles.
Many healthcare providers report difficulties with its integration into existing systems, and the program’s slow implementation has left hospitals scrambling to provide alternatives.
However, just a few months into its implementation, the scheme has faced significant criticism.
MPs across the political spectrum have raised serious concerns over SHAH’s effectiveness, calling it “inadequate” and “unfit for purpose.”
A joint parliamentary committee met earlier this month to address the growing discontent, with several lawmakers questioning how the government could suspend the well-established NHIF without ensuring that SHAH would provide a workable alternative.
“There is a growing sense of frustration,” said one member of the committee.
“Patients and families have been promised a better system, but what they’re getting is a service that is not up to standard. How can we justify a policy that leaves our citizens without health coverage in the interim?”
SHAH’s failures have been particularly glaring in its technical infrastructure.
Our investigations revealed that many hospitals across the country have experienced delays in processing claims, and in some cases, SHAH membership cards are not recognized by healthcare providers at all.
The system’s frequent breakdowns and communication failures have compounded the problem, leading to a rising number of people who are effectively uninsured.
As the government insists that the suspension of NHIF is a temporary measure, with plans to overhaul the health insurance system, patients remain caught in the middle. Many had been relying on NHIF for years as a stable means of accessing healthcare, but now find themselves unable to afford treatment due to the lack of viable alternatives.
At one hospital, a middle-aged woman who arrived for a routine checkup was devastated after learning she could not use her NHIF coverage.
“I’ve been paying into NHIF for years, and now that I need it most, I can’t use it. And SHAH isn’t working either – what am I supposed to do?” she said, her voice filled with frustration.
Across the city, similar stories have emerged, with families struggling to find the resources to pay for medical services. Hospitals are overwhelmed, as those seeking medical care are turned away or forced into costly private alternatives.
Experts warn that the suspension of NHIF without a clear and functional replacement could trigger a healthcare crisis.
The government’s plan to replace the longstanding NHIF with SHAH has been met with skepticism and growing anxiety.
With the system still facing technical difficulties and its coverage far from comprehensive, many are questioning the government’s approach to reforming Kenya’s healthcare system.
As of now, the government has yet to provide a clear timeline for when NHIF services will be reinstated or when SHAH will be fully operational.
Until then, many Kenyans across the nation are left to wonder when they will finally be able to access reliable, affordable healthcare once again.
Stay tuned for further updates on this ongoing healthcare crisis.
