Senate President Pro Tempore Panfilo “Ping” Lacson on Sunday made it clear: He will not sign the Bicameral Conference Committee (Bicam) report on the proposed 2026 national budget unless contentious provisions on medical assistance and farm-to-market roads are corrected.

Lacson objected to the Bicam panel’s decision to boost the budget of the Medical Assistance to Indigent and Financially Incapacitated Patients (MAIFIP) to P51 billion and allocate P33 billion for farm-to-market roads, warning that both moves raise serious concerns about compliance with existing laws and the potential for political patronage.

“Sorry, unless rectified in its final version, I cannot sign to ratify a bicam report with P51 billion for MAIFIP, with nothing but guarantee letters from politicians, and is not compliant with the Universal Health Care Act,” Lacson lamented.

“Further, I will not associate myself with the P33-billion spending for unplanned and unvetted farm-to-market roads,” he added.

During the first day of bicameral deliberations on Saturday, 13 December, lawmakers agreed to raise MAIFIP’s proposed funding to P51 billion —exceeding the P42 billion allocation for 2025, the House proposal of P49 billion, and the Senate-approved level of P29 billion. The Bicam committee also approved P33 billion for farm-to-market roads, higher than the P32 billion in the House version and more than double the P16 billion proposed under the National Expenditure Program (NEP).

Lacson emphasized that all health-related funds should be aligned with the Department of Health’s Universal Health Care (UHC) program to ensure comprehensive coverage and zero patient billing.

“Unless we adequately fund the UHC programs such that they cover all barangays and ensure zero billing, among others, we cannot fully implement the UHC law that we passed,” he said.

“Guarantee letters from politicians will only guarantee patronage politics but not the health care needs of Filipinos, especially the indigents,” he stressed.

Lacson has long raised concerns over MAIFIP, noting that its current setup allows politicians to issue guarantee letters for patients, making the program vulnerable to political exploitation. Often derided by watchdogs as a new form of “pork,” MAIFIP is a Department of Health (DoH) program that provides financial assistance to cover the medical expenses of poor patients but relies on politically issued guarantees.

Health reform advocate Dr. Tony Leachon, a former DoH official, echoed Lacson, calling for the removal of MAIFIP and guarantee letters in the 2026 budget.

“By relying on guarantee letters issued by politicians, MAIFIP remains vulnerable to patronage, inequity, and misuse — precisely the problems that UHC was designed to eliminate,” Leachon wrote on X (formerly Twitter). He also warned that the zero-billing promise at DoH hospitals will not materialize unless all health-related funds are consolidated under UHC.