Senate grills CS Duale over gaps in health insurance regulations

Health Cabinet Secretary Aden Duale was on the spot Thursday as Senators challenged the Ministry of Health’s handling of critical insurance regulations tied to Kenya’s new universal healthcare system.

Appearing before the Senate Committee on Delegated Legislation, chaired by Senator Mwenda Gataya, Duale was questioned about legal compliance and public consultation in the preparation of the Social Health Insurance (Amendment) Regulations, 2025 and the Social Health Insurance (Tariffs for Healthcare Services) Regulations, 2025.

Senators demanded to know why there was no evidence that the public had been engaged before the amendments were published.

Duale defended the Ministry’s approach, saying further consultation was not required.

“Following the Attorney General’s advice, there was no need for additional public engagement since the amendments were based on recommendations already reviewed and adopted by the National Assembly’s Delegated Legislation Committee,” Duale said.

He argued that the original regulations had already undergone “comprehensive and extensive public participation,” which, in the Ministry’s view, satisfied legal requirements.

A second major concern was the missing Regulatory Impact Statement for the tariff regulations. Under Section 6 of the Statutory Instruments Act, such a statement is mandatory. Senators warned that without it, the proposed tariffs could burden households and communities.

Duale assured the Committee that the Ministry had conducted public engagement specific to the tariffs. He said the Ministry published a newspaper advert on June 10, 2024, calling for submissions, which closed on June 17, 2024.

The proposals were also shared online, and feedback was collected through a National Validation Exercise held on August 30, 2024.

He added that the Ministry engaged with relevant parliamentary health committees throughout the process. “The Ministry did not prepare an entirely new Regulatory Impact Statement.”

“Instead, we revised the existing one from 2024 to include the latest stakeholder feedback specifically relating to the tariffs.”

The tariffs are connected to the benefit packages outlined in the Second, Third and Fourth Schedules of the Social Health Insurance Regulations, 2024.

Duale said the revised structure took into account all the input gathered during the process.

The CS took time to explain the purpose of the three funds established under the new system. The Primary Healthcare Fund targets basic and preventive services at the community level.

The Social Health Insurance Fund provides wide coverage, including outpatient and inpatient care, maternity, renal care, oncology, mental health, and various surgeries.

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The Emergency, Chronic and Critical Illness Fund, he said, handles specialised and long-term treatment, palliative and rehabilitative services, and medical devices.

Senators, including Danson Mungatana, Joyce Korir, Daniel Maanzo, Betty Montet, Julius Murgor, Issa Juma Boy, and Mohamed Faki, called for strict adherence to legal procedures.

While they acknowledged the Ministry’s efforts to provide clarity, they stressed that the law must be followed fully in the rollout of such major policies.

The Senate Committee will now scrutinise the Ministry’s submissions before issuing its report, in a session that underlined Parliament’s oversight role in shaping health reforms.