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The unprecedented decision by Congress to withdraw all national budget subsidies for the Philippine Health Insurance Corporation (PhilHealth) in 2025 — and to consider suspending the collection of member premiums —delivers a significant blow to its usual operations.
Even as it grapples with controversies, the agency has attempted to address public health demands by raising benefit packages for conditions like severe dengue and expanding coverage for oral health and heart procedures. Yet lawmakers continue to call for sweeping reforms, with critics arguing that this funding cut threatens Filipinos’ right to accessible healthcare.
On the other hand, Senate Deputy Minority Leader Risa Hontiveros has questioned the constitutionality of granting zero subsidies to PhilHealth under the proposed ₱6.352 trillion 2025 national budget. She maintains that withholding government support undermines the health rights of millions of Filipinos — rights meant to be safeguarded by law.
PhilHealth's travails in 2024 have culminated in the appointment of a new president and CEO.
Below is a concise timeline of PhilHealth’s key developments and controversies from 2024 to 2025, illustrating both the agency’s efforts to expand benefits and the mounting demands for accountability.
Senator Christopher “Bong” Go criticizes unspent PhilHealth funds, particularly the ₱89.9 billion “excess funds” slated for transfer to the National Treasury.
Over 65 medical organizations and former Department of Health leaders voice their opposition to PhilHealth’s proposed fund transfer to the National Treasury.
Senator Go demands accountability from PhilHealth, urging the agency to expand its benefits in accordance with the Universal Health Care Law.
In response to Senator Bong Go’s appeal, PhilHealth has officially scrapped its single period of confinement policy, which previously limited beneficiaries to coverage for the same illness only once within a 90-day period. The policy change took effect on 1 October.
Senator Go renews his call for reforms within PhilHealth, emphasizing the need for preventive measures to avoid more serious and costly health conditions.
A group led by retired Supreme Court Senior Associate Justice Antonio Carpio files a petition for certiorari and prohibition before the Supreme Court, challenging the constitutionality of the ₱89.9-billion PhilHealth fund transfer to the National Treasury.
The Supreme Court grants a motion allowing leaders of the Federation of Free Workers and the NAGKAISA Labor Coalition to intervene in a petition filed by Atty. Sonny Matula, which also questions the ₱89.9 billion transfer.
PhilHealth increases its severe dengue benefit package from ₱16,000 to ₱47,000, effective 1 November 2024, aiming to provide better financial protection for Filipinos battling the mosquito-borne disease.
PhilHealth expands its primary care benefits to include oral health coverage, aligning with the goal of helping Filipinos maintain 20 permanent teeth by age 70. It also raises its dengue benefit package for cases with or without warning signs to ₱13,000.
Despite potential budget cuts in 2024, PhilHealth announces plans to broaden coverage for various cancers, rare diseases, and rehabilitation services. It also aims to enhance coverage for kidney transplants and post-transplant care, following a recommendation to slash over ₱5.7 million from its proposed budget.
Senate Finance Committee Chairman Grace Poe disclosed that PhilHealth will receive zero subsidy in 2025 due to its ₱600 billion reserve funds. This decision was made following the bicameral conference committee meeting on House Bill No. 10800, or the General Appropriations Bill (GAB) which contains the ₱6.352 trillion national budget.
President Ferdinand Marcos Jr. defends the zero-budget allocation for PhilHealth in the 2025 budget, citing the agency’s ₱600 billion in reserve funds. Lawmakers criticize PhilHealth for not maximizing previously allocated resources.
State auditors question PhilHealth’s financial stability, challenging its claims of sufficient reserves and surpluses. Scrutiny intensifies over whether the agency can maintain services despite its purported financial strength.
In response to rising food-related illnesses, PhilHealth expands heart care benefits, significantly increasing financial aid for heart attack-related medical procedures. The benefit for coronary interventions rises by over 1,600 percent to ₱524,000.
PhilHealth continues to owe around ₱4 billion to 1,200 private hospitals for unpaid claims from the pandemic period. Although some debts are partially settled, many hospitals remain unpaid, underscoring the agency’s financial challenges.
Lawmakers call for an investigation into PhilHealth’s failure to pay ₱59.6 billion in hospital reimbursement claims from 2017 to 2024. Despite a ₱492 billion cash reserve, PhilHealth rejects millions of claims, prompting renewed demands for transparency and accountability.
Lawmakers are urging PhilHealth to suspend the collection of premium contributions in 2025 and instead prioritize assisting Filipinos with their medical needs. Marikina Rep. Stella Quimbo reinforced Speaker Martin Romualdez’s call for a moratorium, emphasizing that as a social health insurance program, PhilHealth should focus on serving the public rather than generating profits.
President Ferdinand Marcos Jr. appoints US-trained orthopedic surgeon Dr. Edwin Mercado as the new President and CEO of Philippine Health Insurance Corporation.
