Geline Salac

Philippine Health Insurance Corporation (PhilHealth) manually process their members’ transactions at PhilHealth National Capital Region Central Branch in Quezon City on Tuesday, September 28, following the shutdown of their online system due to a cyberattack last week. 
PhilHealth advise their members and their qualified dependents to present a copy of their PhilHealth identification card, member data record, or other supporting documents to access health benefits amid the temporary shutdown of its online system.Maria Tan, ABS-CBN News

Article (news)

PHILHEALTH

Raine Musñgi

ABS-CBN News

MANILA — PhilHealth expects to pay out a record P378 billion to P400 billion in health insurance benefits this year as the Marcos administration accelerates the expansion of healthcare coverage for Filipinos, including bigger benefit packages for paying members.Speaking on ANC&#x27;s Business Outlook, Mae Villa, Acting Vice President for Corporate Affairs of PhilHealth, said the corporation has substantially increased benefit payments while keeping premium contribution rates unchanged.The projected payout, the highest in the history of the state insurer, comes as Executive Secretary Ralph Recto called for larger PhilHealth benefits for members who consistently pay their monthly contributions, saying they should receive healthcare packages commensurate with what they contribute every year.Recto said many middle-class contributors have long questioned why they shoulder annual premiums of P30,000 to P60,000 yet often feel they receive limited benefits when they need medical care.&quot;Ayon sa batas, iba ang benefit package para sa kanila. Dagdagan natin ito,&quot; Recto said in a recent radio interview, adding that paying members deserve to feel the value of their contributions. (&quot;According to the law, the benefit package for them is different. Let&#x27;s increase it.&quot;)That policy direction is already reflected in PhilHealth&#x27;s aggressive expansion of benefit packages over the past two years.&quot;In compliance with the Universal Health Care Law, PhilHealth implemented across-the-board benefit increases in 2024 by 30 percent. On top of that, in 2025, we also implemented an additional 50 percent, equivalent to a compounded increase of 95 percent,&quot; Villa said. Those expanded benefits have translated into a dramatic rise in healthcare spending.Villa said PhilHealth paid P119 billion in benefit claims in 2023. Benefit payments jumped to P295 billion in 2025, and are projected to reach between P378 billion and P400 billion by the end of 2026.<div><iframe width="640" height="360" src="https://www.youtube.com/embed/SzVWShOoiTc?&amp;t=2s&amp;wmode=opaque&amp;rel=0" frameBorder="0" allowfullscreen="" class="fr-draggable"></iframe> </div>The projected payouts will exceed PhilHealth&#x27;s expected collections from premium contributions and government subsidies this year, making the agency increasingly dependent on investment income, reserve funds and government support to sustain expanded healthcare coverage.<div>Healthcare spending reaches a new normal</div>Villa said the rapid expansion of healthcare benefits reflects the government&#x27;s commitment to fully implementing the Universal Health Care Act, but also fundamentally changes PhilHealth&#x27;s long-term financial requirements.&quot;The challenge for PhilHealth and the government is really to strike the right balance between benefit expansion and financial sustainability. We want to maximize the value that our members receive... while also maintaining sufficient reserves to ensure that PhilHealth remains viable for future generations.&quot; She acknowledged that healthcare spending is entering what PhilHealth now considers a new baseline.&quot;The cost of healthcare and a massive benefit expansion has significantly increased and may continue to increase in the coming years.&quot; Because of this, PhilHealth has begun discussions with lawmakers, economic managers and budget officials on a long-term financing framework that will allow the agency to continue expanding benefits without compromising its financial position.&quot;We&#x27;re engaging our policymakers, our budget officials and the legislators in discussions on the long-term financing framework for universal healthcare.&quot; Villa cited PhilHealth President and CEO Dr. Edwin Mercado, who has emphasized that sustaining broader healthcare benefits will require policy changes beyond simply collecting more premiums.&quot;The baseline for healthcare spending has actually changed and sustaining broader benefits in the years ahead will really require a corresponding shift in policy and more sustainable health financing frameworks.&quot; <div>No premium hike despite rising costs</div>One notable feature of PhilHealth&#x27;s expansion is that it has not been accompanied by higher contribution rates.The premium contribution remains at 5 percent of monthly basic income in 2026, the final rate prescribed under the Universal Health Care Act. For employed members, the premium continues to be shared equally by employers and employees.Instead, PhilHealth says it is relying on multiple funding sources, including premium collections, national government subsidies for indirect contributors, proceeds from sin taxes, contributions from PAGCOR and the Philippine Charity Sweepstakes Office, as well as investment earnings.&quot;I&#x27;d like to assure everyone that PhilHealth has a robust financial situation.&quot; The agency also recently regained P60 billion in reserve funds previously transferred to the National Treasury following a Supreme Court ruling, providing additional fiscal space to finance expanded benefits and help cover the projected funding gap this year.<div>Lower medical bills, stronger economy</div>Villa said the expansion of PhilHealth benefits goes beyond healthcare.Reducing out-of-pocket medical expenses, she said, also strengthens household finances and economic productivity.&quot;Illness and rising medical costs may really drive a person or his or her family to poverty.&quot; She said every peso families save on hospital bills and medicines can instead be spent on education, food, housing and other household needs.&quot;Lowering household out-of-pocket costs will contribute towards improvement of our productivity and economic stability.&quot; The Philippine Statistics Authority has consistently identified healthcare spending as a major component of household expenditures, while out-of-pocket payments remain one of the biggest barriers to healthcare access.<div>Universal healthcare requires more than PhilHealth</div>While acknowledging public frustration over hospital bills and gaps in healthcare delivery, Villa stressed that universal health care cannot rest solely on the state insurer.&quot;PhilHealth cannot be the only one doing all the work for making sure that universal healthcare is achieved.&quot;She said stronger primary healthcare, adequate government funding, sufficient hospital capacity, timely reimbursements and cooperation from healthcare providers are all essential if Filipinos are to fully benefit from the Universal Health Care Act.For PhilHealth, the next challenge is no longer whether benefits should be expanded since they already have been.The bigger question now is whether government can sustain record healthcare spending while keeping contributions affordable for millions of Filipino workers.

Benefit payments jumped to P295 billion in 2025, and are projected to reach between P378 billion and P400 billion by the end of 2026.

Benefit payments jumped to P295 billion in 2025, and are projected to reach between P378 billion and P400 billion by the end of 2026.

PhilHealth eyes P400-billion in payouts amid push for bigger benefits for paying members

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PhilHealth eyes P400-billion in payouts amid push for bigger benefits for paying members

Raine Musñgi,

ABS-CBN News

Published June 26, 2026 01:00 PM PHT

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PhilHealth

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