Health insurance coverage could surge significantly

Kathmandu, August 24

Health insurance coverage could surge significantly if the proposed health insurance law is endorsed from the Parliament, as it has a provision of mandatory insurance coverage for immediate family members of those employed in formal sector, of civil servants, and of migrant workers.

This provision has been included in Health Insurance Bill 2017, which was tabled at Legislature-Parliament on April 12. If the bill gets endorsed and law is implemented effectively, officials estimate additional 500,000 Nepalis would get insurance coverage in the very first year that the programme is rolled out.

According to former health minister Gagan Thapa, who had tabled the bill at the Parliament, the passage of the bill would be a major milestone in ensuring access to health facilities for the family members of the aforementioned groups.

“We included migrant workers to the list as we realised that their family members are often unable to afford basic health care, especially with the migrant worker who is usually the breadwinner of the family out of the country,” explained Thapa.

Thapa also informed that after the bill gets approved from Parliament, the government could even offer insurance policies at subsidised rates for disadvantaged groups. “Our concept was to offer certain discount on the policies for those who are not financially capable to pay the full sum.”

Proposed as part of the government’s plan to expand Nepal’s health insurance coverage, Thapa said the government could also encompass people engaged in informal sector by offering attractive discounts to them. The premium and coverage would be decided after the bill gets endorsed, he said.

The government is at present offering public health insurance policy, which has set premium for a family of five at Rs 2,500, with medical coverage worth Rs 50,000.

Currently, Social Health Security Development Committee (SHSDC) is implementing public health insurance policy in 15 districts. It is being rolled out to seven more districts in September. According to Gunaraj Lohani, director of SHSDC, a total of 233,000 families have taken the health insurance policy till date. The enactment of the new law could benefit around 500,000 people in the first year alone, he estimated.

The government has defined family members as those living in the same house — husband and wife and their children, father and mother or step mother, brother and sister, and grandson and granddaughter. Likewise, if the person taking the policy is unmarried, their grandfather and/or grandmother can be incorporated as family member. If the policy holder is a married woman, her father-in-law and mother-in-law also can be counted as family members.