President William Ruto has shared the government’s plan to settle the outstanding Ksh33 billion debt owed by the National Health Insurance Fund (NHIF), a situation that has negatively impacted the implementation of the new Social Health Authority (SHA).
This debt has been a major challenge, affecting the smooth operation of healthcare services across the country.
On Wednesday, March 5, President Ruto confirmed that by the time NHIF ceased operations on November 22, 2024, it had accumulated a debt of Ksh33 billion. However, he assured the public that there was a well-organized plan to resolve this issue.
He pointed out that the mounting debt had caused significant disruptions in healthcare services, restricting hospitals’ ability to provide vital medical care to the people of Kenya.
To tackle this issue, Ruto explained that the government had made a key decision to settle all the outstanding claims from healthcare facilities contracted by NHIF that were worth Ksh10 billion or less.
He noted that these facilities represented a substantial 91 percent of the total hospitals that were owed money by the government.
This move is expected to bring immediate relief to many healthcare providers who have been struggling with delayed payments.

For the remaining 9 percent of hospitals, which have claims exceeding Ksh10 million, the President clarified that a verification process would be conducted.
This verification exercise is expected to take about 90 days to complete. He also mentioned that Cabinet Secretary for Health, Deborah Barasa, would be responsible for establishing a verification committee, with the intention to gazette it within a week.
Additionally, Ruto emphasized that under the newly established Social Health Authority (SHA), the government would continue to settle current claims within a month.
Since the rollout of SHA on October 1, 2024, the authority has already disbursed Ksh18.2 billion to cover all undisputed claims up to January 31, 2025. This shows the government’s commitment to clearing healthcare-related debts in a timely manner.
However, despite these positive steps, the Social Health Authority is facing several challenges, particularly regarding funding. A recent report by Auditor General Nancy Gathungu revealed concerning issues, such as the 2.5 percent deduction from member contributions to SHA, which was being transferred to an escrow account without proper transparency or oversight. Other challenges include uncompetitive procurement processes, a lack of payment agreements, and unfavorable contract terms.
In response to these challenges, the Rural and Urban Private Hospitals Association (RUPHA), led by Chairperson Brian Lishenga, criticized the government for allegedly trying to solve the debt issue by taking money from Kenyans’ SHA contributions.
Lishenga emphasized that the best way to resolve the debt crisis was through a supplementary budget, rather than placing the burden on citizens.
As President Ruto reaffirmed the government’s dedication to addressing the issues surrounding SHA, Treasury Cabinet Secretary John Mbadi appeared before the Senate on Wednesday to discuss the financial situation.
Mbadi confirmed that there would be allocations in the supplementary budget to support SHA, Primary Healthcare, and Critical Healthcare services.
This comprehensive approach highlights the government’s efforts to resolve the NHIF debt and improve the functioning of the Social Health Authority to better serve the healthcare needs of Kenyans.

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