A few days after Christmas, PhilHealth announced that starting 1 January 2025, case rates would increase by 50 percent across nearly 9,000 benefit packages. It was framed as a breakthrough --more financial protection, fewer out-of-pocket expenses and better healthcare access.

But just days before, the government stripped PhilHealth of its national budget allocation and ordered it to remit P89.9 billion of its reserves to the National Treasury. P60 billion was already transferred. PhilHealth is being asked to pay out more while receiving less, all while its reserves are being tapped for other uses. So, where is the money going? And what happens when it runs out?

The budget realities: Who gets funded, who gets left behind

The Department of Health’s 2025 budget is P247.56 billion, a 2.69 percent increase from last year. But that doesn’t tell the whole story. Total public health spending actually declined by 3.5 percent, and PhilHealth received zero government subsidy — a stark contrast to the P01.51 billion it received in 2024 and P100.2 billion in 2023. Officials justified this by pointing to PhilHealth’s P600 billion in reserves, arguing it didn’t need additional funding. Yet at the same time, the government took nearly P90 billion from those reserves, raising the question: If PhilHealth has enough, why does it need to surrender such a large sum?

Meanwhile, other agencies saw their budgets expand. The Department of National Defense (DND) increased to P282.7 billion, nearly 10 percent more than last year. Confidential and intelligence funds across various offices remained substantial, even after a reported reduction. Security and intelligence operations are vital, but where does healthcare rank in national priorities? If universal healthcare is a national commitment, why is PhilHealth expected to “stand on its own” while other sectors receive full government support?

The first zero-subsidy year: A dangerous precedent?

PhilHealth has historically received steady government support. In 2023, the National Health Insurance Program (NHIP) was allocated P100.2 billion, a 25.3 percent increase from 2022. By 2024, it had grown modestly to P101.51 billion. Then, in 2025, that support vanished.

If PhilHealth required government funding in previous years, how is it suddenly expected to sustain itself without a single peso — while also increasing benefits? And if its financial position is so strong, why did the government take nearly P90 billion from its reserves? This move sets a precedent: if the government can take PhilHealth’s money once, what’s stopping it from doing it again?

Where did PhilHealth’s money go?

On 19 December 2024, PhilHealth transferred P60 billion to the National Treasury, with another P29.9 billion due in 2025. The government claims 78 percent of these funds were allocated to healthcare needs, including Covid-19 benefits for medical workers, indigent patient assistance and public health projects.

These are critical initiatives. But if they were so important, why weren’t they directly funded in the national budget instead of pulling from PhilHealth’s reserves? This raises sustainability concerns. PhilHealth’s 2025 budget is P284 billion, with P271 billion already committed to benefit payouts. That leaves almost no room for unexpected costs. What happens when the next crisis hits? The likeliest outcomes: delayed hospital reimbursements, stricter claims processing and, eventually, higher contribution rates for members.

And if that sounds familiar, it’s because it’s happened before.