Zero-balance billing may expand to LGU hospitals

The Department of Health plans to extend its zero-balance billing program to select local government unit hospitals, following a Senate allocation of P1 billion. Health Secretary Ted Herbosa announced the initiative, which has already benefited over one million patients since July. Senator Pia Cayetano emphasized the need for full funding to PhilHealth to make the program nationwide.

The Department of Health (DOH) has revealed intentions to include local government unit (LGU) hospitals in its zero-balance billing program. Speaking on a radio program, Health Secretary Ted Herbosa noted that the Senate had inserted P1 billion in funding for this purpose. "The Senate has inserted P1 billion to be used as zero-balance billing support to local government hospitals," Herbosa stated. He added, "So it will not just be DOH hospitals... if released, we can select a few LGU hospitals that are deserving. We can give them funds so they can also implement the zero-balance billing policy."

Launched after President Ferdinand Marcos Jr.'s State of the Nation Address in July, the program has assisted 1,078,164 patients in just four months. It covers hospital services without requiring payment from patients, including medical procedures, doctors' professional fees, and medications.

However, Senator Pia Cayetano highlighted challenges in achieving broader implementation. She argued that the program would function effectively if the Philippine Health Insurance Corp. (PhilHealth) received all earmarked funds as required by law. Cayetano's comments followed a Supreme Court ruling declaring the 2024 transfer of P60 billion from PhilHealth to the national treasury illegal.

"If PhilHealth was given every peso intended for it, the promise of zero-balance billing would not be limited to a few hospitals. It could be a real, functioning guarantee for every Filipino patient," Cayetano said in a statement. She pointed to funding shortfalls: in 2023, P83.9 billion was earmarked but only P79 billion appeared in the General Appropriations Act, creating a P4.9-billion gap. For 2024, P79.01 billion was allocated versus P40.28 billion in the GAA, resulting in a P38.73-billion deficit. In 2025, the P69.81 billion earmark was entirely removed by the bicameral conference committee. For 2026, P69.78 billion is earmarked against P53.26 billion in the National Expenditure Program, potentially leaving a P16.52-billion shortfall.

PhilHealth estimates it requires at least P147 billion more to subsidize indirect contributors and extend zero-balance billing to all DOH hospitals, specialty institutions, and LGU facilities. Cayetano warned, "We cannot celebrate the Supreme Court ruling and then continue underfunding PhilHealth in the very same budget cycle."

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