A tidal wave of anger and disbelief is sweeping across Kenya following revelations that the Social Health Authority (SHA), the government’s flagship universal healthcare program, has quietly scrapped its monthly contribution model, now requiring Kenyans to pay a staggering Ksh12,460 in a single lump sum to access medical services.
The abrupt policy shift, which reportedly took effect in June 2025, has blindsided citizens, leaving thousands unable to afford healthcare and facing rejection at hospitals and clinics nationwide.
The SHA, launched with much fanfare as a replacement for the National Health Insurance Fund (NHIF), was touted as a transformative step toward affordable, equitable healthcare for all Kenyans.
It promised to streamline access to medical services, reduce out-of-pocket costs, and ensure that even the most vulnerable could receive treatment without financial ruin.
However, the sudden demand for a full year’s contribution upfront—equivalent to 12 months of the previous Ksh1,038 monthly payments—has shattered those expectations, plunging families into desperation and sparking accusations of betrayal by the government.
Policy Change Shrouded in Silence
Reports indicate that the change was implemented with little to no public communication, catching both patients and healthcare providers off guard.
Across the country, Kenyans seeking treatment at hospitals and clinics have been turned away, informed that their SHA accounts are “inactive” unless they settle the Ksh12,460 lump sum.
For many, this amount represents a significant portion of their annual income, particularly for low-income households already grappling with rising costs of living.
“I went to the hospital because my daughter was running a high fever,” said Jane Wambui, a single mother and vegetable vendor in Nairobi’s Dandora estate.
“They told me I couldn’t be served because I hadn’t paid the full year’s contribution. Where am I supposed to get Ksh12,460? The government promised us affordable healthcare, but this feels like a slap in the face.” Wambui’s story is far from isolated.
From Mombasa to Kisumu, social media platforms and community forums are ablaze with accounts of patients being denied critical care, including dialysis, cancer treatment, and maternity services, due to the new payment requirement.
In rural areas, where access to cash is often limited, the policy has been particularly devastating, forcing some to resort to borrowing from predatory lenders or forgoing treatment altogether.
Broken Promise of Universal Healthcare
The SHA was introduced to address longstanding criticisms of the NHIF, which was plagued by allegations of mismanagement, corruption, and inefficiencies.
The government assured Kenyans that the new system would prioritise accessibility and affordability, with monthly contributions designed to ease the financial burden on low- and middle-income families.
The shift to a lump-sum payment model, however, has been widely condemned as a betrayal of that promise.
“This is not universal healthcare—it’s a system designed to exclude the poor,” said Dr James Otieno, a public health advocate based in Eldoret.
“The government knew that demanding such a large upfront payment would lock millions out of healthcare. They’ve turned a public good into a privilege for those who can afford it.”
Critics argue that the policy disproportionately affects informal sector workers, who make up a significant portion of Kenya’s workforce.
Unlike salaried employees, whose contributions are deducted directly from their pay cheques, informal workers such as traders, farmers, and casual labourers often rely on irregular incomes, making it nearly impossible to raise Ksh12,460 in one go.
Government Silence Fuels Public Fury
The lack of transparency surrounding the policy change has only deepened public outrage. As of June 14, 2025, the Ministry of Health and the SHA have issued no official statement explaining the rationale behind the decision or outlining measures to support those unable to pay.
Attempts by journalists to reach SHA officials for comment have been met with vague responses or outright silence, further eroding public trust.
Opposition leaders and civil society groups have seized on the issue, accusing the government of prioritising fiscal targets over the welfare of its citizens.
“This is a deliberate attempt to undermine the right to healthcare enshrined in our Constitution,” said Martha Ng’ang’a, a spokesperson for the Kenya Human Rights Commission. “The government must reverse this policy immediately and engage in meaningful dialogue with the public.”
Hospitals Caught in the Crossfire
Healthcare facilities, too, are grappling with the fallout. Hospital administrators report receiving no clear guidance from the SHA on how to implement the new policy, leaving them to bear the brunt of patients’ frustration.
“We’re in an impossible position,” said Dr Susan Mwangi, a hospital manager in Nakuru. “We can’t treat patients unless their SHA accounts are active, but we’re seeing people in critical condition who simply can’t pay. It’s heartbreaking.”
Some facilities have resorted to offering temporary credit or waiving fees for emergency cases, but these measures are unsustainable without reimbursement from the SHA.
Meanwhile, reports of patients being detained in hospitals over unpaid bills—a practice the SHA was meant to eliminate—have resurfaced, further undermining confidence in the system.
Nation in Crisis
The policy change comes at a time when Kenya is already grappling with economic challenges, including high inflation, unemployment, and a weakening shilling. For many families, the Ksh12,460 payment is not just a financial burden but an insurmountable barrier.
Community leaders warn that the crisis could exacerbate existing inequalities, pushing vulnerable populations deeper into poverty and ill health.
In informal settlements like Kibera and Mathare, residents have begun organising protests to demand the reinstatement of monthly payments.
“We will not sit quietly while our people are left to die,” said Joseph Omondi, a community organiser in Kisumu. “The government must listen to us, or we will take to the streets.”
Call for Accountability
As the crisis unfolds, pressure is mounting on the government to address the growing unrest.
Health policy experts are calling for an urgent review of the SHA’s funding model, including subsidies for low-income households and a return to flexible payment plans.
Others are urging the government to release data on how SHA funds are being utilised, amid suspicions that the lump-sum requirement may be an attempt to shore up the agency’s finances.
For now, millions of Kenyans are left in limbo, caught between a healthcare system that promised salvation and a reality that feels like abandonment.
As the nation waits for answers, the voices of the sick, the desperate, and the outraged grow louder, demanding justice and a healthcare system that truly serves all.
