THE Philippine Health Insurance Corp. (PhilHealth) is willing to accept another year of losses as it expands benefit packages and continues to rely on government funding to sustain the country’s universal health insurance system.
Speaking to reporters at the sidelines of a news briefing last Thursday, PhilHealth Senior Vice President for Fund Management Sector Renato Limsiaco Jr. said the insurer’s thrust is to strengthen benefits for members rather than restrain spending to break even.
This comes as PhilHealth’s net loss, wider by 21.63 percent year-on-year to P17.902 billion in the first quarter of 2026, is expected to narrow this year.
The insurer’s expenses, mostly for benefit claims, amounted to P99.893 billion in the first quarter, outpacing income at P77.047 billion.
For the full year, PhilHealth expects benefit claims to reach P378.786 billion, which will be funded by premium contributions worth P246.920 billion, along with government subsidy, interests and other income and retained earnings.
Subsidy from the national government, such as the P53 billion in shares from sin taxes and P16 billion earmarked for benefit improvements, will also support PhilHealth’s operations this year, Limsiaco said.
‘Right now, I can’t see that we’re going to break even because if you’re going to break even, you control the expenses,’ Limsiaco said. ‘But we still have retained earnings. We still have reserve funds. Why would we control the expenses? People need support.’
As of end-March, PhilHealth’s retained earnings stood at P76.244 billion and will be boosted by the P60 billion returned by the national government last April.
To recall, PhilHealth remitted P89.9 billion of its reserve funds to the Treasury in 2024 to fund the unprogrammed appropriations in the national budget.
‘If it is not enough, we still have a buffer that we can use to cover the requirements,’ Limsiaco said. ‘We can still manage it. We just need to push for the [national government] counterpart so that we can continue covering the costs.’
PhilHealth has initially requested a budget of P370 billion for 2027 to implement its expanded benefits.
However, the government only accommodated P74.448 billion under the 2027 National Expenditure Program, slashing PhilHealth’s proposal by nearly 80 percent. This is also 74.32 percent lower than this year’s allocation of P129.782 billion.
PhilHealth’s financial sustainability is becoming strained as benefit claims are rising faster than its premium collections, driven by the insurer’s tack to ramp up benefit packages and widen healthcare coverage for its members.
In 2025, PhilHealth rolled out its ‘Yaman ng Kalusugan’ program, or ‘Yakap’ (embrace), offering an expanded package of accessible health services, including primary care checkups, medicines, basic laboratory tests and screening.
Limsiaco said Yakap could contain the increase in benefit claims of hospitals, as greater access to primary care, early detection and early treatment would reduce the need for more expensive hospital-based care.
The impact, however, may take time to materialize, with PhilHealth expecting to see the results over the next three years as the program is expanded.
PhilHealth has P308.950 billion in reserve funds to date, which Limsiaco said could be used if additional resources are needed to support benefit packages.
The insurer has also accumulated P31.135 billion in interest income from reserve funds as of end-March.
‘For now, we just need to continue improving the system, improving benefit packages, making sure people can avail themselves of the benefits, [and] speeding up claims processing,’ he said.