By Dawan Reporter - Reporter
Kenya, 12 November 2025 - A tense atmosphere pervaded proceedings in the Senate on Tuesday as lawmakers clashed over the implementation and fairness of the Social Health Authority (SHA) scheme, which has replaced the National Hospital Insurance Fund (NHIF).
The exchange laid bare profound concerns about escalating contribution costs and unfulfilled pledges of universal health coverage.
The row erupted when Nairobi Senator Edwin Sifuna, who is the Secretary-General for Orange Democratic Movement (ODM), rose to deliver his statement.
“I am not misled,” Mr Sifuna declared, alluding to assurances by the President that “harambees for raising hospital bills would be a thing of the past”.
Yet, he added, the reality on the ground paints a different picture.
Mr Sifuna told the House that his monthly contribution under SHA had leapt from “less than a thousand” shillings under NHIF to about KSh 33,000 in the new graduated payment structure.
He said the message originally conveyed to Kenyans – that higher earners would subsidise those with little or no income – has not materialised into the promised relief for low-income households.
“Are Kenyans still holding harambees to fund medical care? Yes, they are,” he stated bluntly.
Chairing the session, Speaker Amason Kingi reminded senators that the SHA scheme is enshrined in law, not based on campaign rhetoric.
“The matter of SHA is no longer based on a promise that was made somewhere,” the Speaker said.
He urged members to consult the Social Health Insurance Act and its regulations rather than relying on recollections of speeches when assessing performance.
During the back-and-forth, Mr Sifuna challenged his colleagues to recall what was approved in the law.
"Did the legislation mandate full coverage of all hospital bills," he asked, "or a percentage?"
He pointed to the Act.
“Under that law … did you pass that the entire amount was supposed to be covered by SHA … or was it under the law you passed a percentage of the total amount?”
The intention was to underscore a perceived discrepancy between public expectations and the legal reality.
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Further fuelling the debate, Mr Sifuna accused some senators of hypocrisy.
He reminded them that he had opposed the SHA Bill in the past and had tabled amendments—some capping contribution levels—only to be voted down.
“Some of these heckling senators are the ones who voted for this law and are now here telling us it is working but people are dying,” he said.
After being asked to withdraw the word “heckler”, he replaced it with “heckling”.
But beyond the rhetoric of the chamber, a series of recent official disclosures lend credence to senators’ concerns: On 14 October 2025, Health Cabinet Secretary Aden Duale announced that the government would introduce a flat-rate premium of Sh660 per month for vulnerable Kenyans under the SHA scheme.
On 19 September 2025, it was reported that the government would cover contributions for more than 2.2 million vulnerable citizens as part of the rollout.
A detailed August report found that although millions had registered for SHA, only a small number had paid contributions.
Private-sector facilities reported payment settlement rates of just 27%.
The Senate ICT Committee highlighted the scheme’s failure to pay counties on time.
In October, they vowed to press SHA to release withheld funds.
These figures underpin senators’ frustration and serve as tangible evidence that the scheme’s promise—to replace the old NHIF with comprehensive coverage for all—remains unfulfilled.
During the session, Mr Sifuna referenced the President’s recent remarks urging patients asked for money in public hospitals to report the matter to the police.
“On what law was he basing that promise?” Sifuna asked.
“When you speak from the office of the president … you are not allowed to give information that is misleading.”
Speaker Kingi reminded senators that the Public Officers Ethics Act obliges officials to avoid misleading the public.
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