In a strongly worded statement, the Narok Senator criticised the requirement compelling Kenyans who already possess valid private medical insurance to also register under SHA, arguing that the system is becoming counterproductive rather than supportive.
“We must urgently review and correct the current SHA Insurance arrangement. Forcing SHA on people who already have valid insurance is unnecessary, unreasonable, and counterproductive,” Olekina stated.
The senator further claimed that the existing structure is distorting how medical claims are processed between hospitals, SHA and private insurance providers.
According to Olekina, some insurers are now demanding confirmation that SHA will first settle 30 per cent of a medical bill before they process the remaining 70 per cent covered under private insurance arrangements.
“The current setup is also distorting claims processing, with insurers now demanding confirmation that SHA will pay 30% before honoring their 70% share,” he said.
He warned that the arrangement is causing delays in treatment and creating operational difficulties for hospitals, which are being forced to navigate multiple layers of payment approvals before offering services to patients.
“This is obstructing care, shifting burdens unfairly onto hospitals, and defeating the purpose of the system,” Olekina added.
The remarks add to the growing national debate surrounding the implementation of SHA, which replaced the National Health Insurance Fund (NHIF) as part of the government’s broader healthcare reforms aimed at achieving universal health coverage.
Since its rollout, the new system has faced criticism from sections of Kenyans, healthcare providers and civil society groups over operational challenges, delayed reimbursements and concerns regarding registration requirements.
Healthcare stakeholders have also raised concerns about coordination between SHA and private insurers, particularly in cases where patients already maintain comprehensive private medical cover.
Some hospitals have previously reported delays in approvals and uncertainty over payment structures, issues that medical professionals say could affect patient access to timely treatment.