Zero-balance billing may expand to LGU hospitals

MANILA, Philippines — The Department of Health has announced its plan to cover local government unit (LGU) hospitals under its zero-balance billing program.

In a radio program yesterday, Health Secretary Ted Herbosa said “the Senate has inserted P1 billion to be used as zero-balance billing support to local government hospitals.”

“So it will not just be DOH (hospitals)... (The amount) if released, we can select a few (LGU hospitals) that are deserving. We can give them funds so they can also implement the zero-balance billing policy,” Herbosa said.

The DOH said 1,078,164 patients have benefited from the zero-balance billing program in just four months following the President’s State of the Nation Address last July.

Under the program, no payment is required from the patient for hospital services including medical procedure, doctor’s professional fee and medications.

PhilHealth funding

Meanwhile, Sen. Pia Cayetano said the zero-balance billing program could work as intended if the Philippine Health Insurance Corp. (PhilHealth) was given the billions already earmarked for it under the law.

“If PhilHealth was given every peso intended for it, the promise of zero-balance billing would not be limited to a few hospitals. It could be a real, functioning guarantee for every Filipino patient,” Cayetano said in a statement yesterday.

Her remarks came in the wake of a Supreme Court ruling that declared illegal the transfer of P60 billion in PhilHealth funds to the national treasury in 2024.

“This is not a matter of an unfunded law. This is earmarked. So where did that go? What is clear is that the Sin Tax Reform Act of 2019 earmarks the proceeds of the sin tax for PhilHealth. If this is not delivered to PhilHealth, I do not want this body to be complicit in this act,” she said.

For 2023, she said P83.9 billion was earmarked for PhilHealth but only P79 billion appeared in the General Appropriations Act (GAA), resulting in a P4.9-billion shortfall.

In 2024, P79.01 billion was earmarked, but only P40.28 billion was included in the GAA, leaving a P38.73-billion deficit.

For 2025, P69.81 billion was earmarked, but the allocation was removed entirely by the bicameral conference committee.

For 2026, P69.78 billion is earmarked, but only P53.26 billion appears in the National Expenditure Program, creating a potential deficit of P16.52 billion.

“These gaps are not technicalities. They are the reason the zero-balance billing has not become fully operational,” she added.

PhilHealth has estimated it needs at least P147 billion more to fully subsidize indirect contributors and implement zero-balance billing across DOH hospitals, specialty institutions and LGU facilities.

“We cannot celebrate the Supreme Court ruling and then continue underfunding PhilHealth in the very same budget cycle,” Cayetano said. — Neil Jayson Servallos