SHA Clarifies Contribution Rates, Explains How Much Kenyans Ought to Pay

The Social Health Authority (SHA) has defended its Means Testing Instrument following public criticism and allegations that its artificial intelligence-driven assessment system unfairly burdens low-income households while allegedly undercharging wealthier individuals.

The controversy follows an investigative report by Africa Uncensored, which claimed that the system used to determine Social Health Insurance Fund contributions may be disadvantaging poorer Kenyans. 

The report alleged that some low-income households are assigned premium payments that are difficult to afford, while higher-income earners appear to contribute relatively less within the current framework.

In response, SHA strongly rejected the claims, arguing that the previous National Health Insurance Fund (NHIF) system was unsustainable because it relied heavily on formal sector contributors and failed to capture the broader population under a fair risk-sharing model.

The authority explained that the new Social Health Insurance Act, 2023 introduced a contribution structure set at 2.75 percent of household income, with a minimum monthly payment of 300 shillings. 

According to SHA, the framework was designed to ensure fairness, inclusivity, and long-term sustainability in healthcare financing.

SHA further illustrated its position using income comparisons, noting that a person earning one million shillings monthly contributes about 1,700 shillings, while someone earning 10,000 shillings pays around 500 shillings. 

Critics, however, argue that such a structure may still place a heavier proportional burden on lower-income earners.

The authority also stated that most households in the informal sector fall within lower contribution bands, with more than 90 percent assessed below 850 shillings per month, while only a small percentage fall into higher payment categories.

To address concerns of inequality, SHA highlighted safeguards such as integration with national social protection databases to identify vulnerable households, whose contributions are fully subsidised by the government under what it describes as an exclusion-by-inclusion mechanism.

The agency also introduced flexible payment options under the “Lipa SHA Pole Pole” arrangement, allowing members to contribute daily, weekly, monthly, or annually depending on their financial capacity.

Additionally, SHA said an appeals and alternative dispute resolution system has been established to allow citizens to challenge assessments and request corrections where errors are identified.

Despite criticism, the authority insists the system is continuously improving and is based on verified data aimed at ensuring fairness in national health financing while expanding coverage across all income groups in Kenya.