The 2026 health budget: Turning healthcare from an entitlement to an act of mercy

The 2026 General Appropriations Bill has completed the bicameral conference committee proceedings, and the budget is set to be ratified by both houses of Congress on Dec. 29.

Healthcare workers remain deeply troubled by the 2026 health budget. Seventy-two (72) healthcare professional organizations, led by the Philippine Medical Association (PMA) and the Philippine College of Physicians (PCP), are disheartened that our legislators have once again failed to allocate our national health insurance provider, PhilHealth (the Philippine Health Insurance Corp.), its legally mandated funds under the Universal Healthcare Act.

The bicam allocates a total of P69.78 billion for the Philhealth insurance premiums for the poor. While this represents an increase from the P53.26-billion proposal in the National Expenditure Program, this allocation still falls short of the government’s obligation under the Universal Health Care (UHC).

The UHC Act mandates the National Government to fully subsidize the premiums of 24.5 million indirect contributors. Therefore, the PhilHealth budget for 2026 should be at least P147 billion. The current allocation of P69.78 billion still leaves a significant funding gap. In addition, the budget, as it stands, fails to include the UHC Act-mandated shares of PhilHealth from Philippine Amusement and Gaming Corp. (PAGCOR) and the Philippine Charity Sweepstakes Office (PCSO).

While the government publicly takes pride in the 2026 PhilHealth budget being its “biggest budget ever,” it is a misleading announcement as it conveniently fails to point out that the budget only seems higher because it includes the P60 billion in PhilHealth funds stolen in 2024 and ordered returned to the agency by the Supreme Court in a recent decision.

Healthcare workers were also outraged by the bicam’s bloated P51-billion budget allocation for the Medical Assistance for Indigent and Financially Incapacitated Patients (MAIFIP) program. MAIFIP is just a supplement to PhilHealth funds but strikingly, from 2023 to 2025, its budget was more than twice that of PhilHealth.

The House of Representatives Panel in the bicam defended their proposal to increase the MAIFIP, to which the Senate Panel yielded without resistance. The House justified that if their version of the MAIFIP budget is not adopted, the number of beneficiaries would be reduced by 1.1 million. This is outrageous considering that the P51 billion could pay for the PhilHealth insurance of more than 8 million poor Filipinos.

Although social media attention highlights a single issue related to the MAIFIP — the guarantee letter — this issue is only the tip of a much larger structural problem.

First, MAIFIP operates as a discretionary rather than a rule-based fund, making it susceptible to political influence and interference. This vulnerability is not theoretical; it has already been demonstrated in practice, and can still happen despite the proposed special provisions.

Second, because MAIFIP is not a standard health benefit, patients are required to apply and prove extreme need and inability to pay. This effectively forces sick Filipinos to beg for assistance before legislators, local officials, or hospital personnel. This is a travesty. Healthcare should be an entitlement, not an act of mercy.

Third, MAIFIP adds to an already fragmented and burdensome system of financial assistance. Patients must navigate multiple programs (MAIFIP, AICS or Assistance to Individuals in Crisis Situation, PCSO, PAGCOR, and others), each with different offices, forms, and requirements. These bureaucratic hurdles increase the burden on those already facing illness or caring for family members.

Fourth, MAIFIP is a duplication of the core function of PhilHealth. Its funding diverts resources that should instead be used to strengthen PhilHealth coverage, particularly for the 24.5 million Filipinos who cannot afford to pay for health insurance.

Fifth, as a discretionary health fund, MAIFIP lacks clear rules and accountability. Unlike PhilHealth benefits, there are no transparent standards defining eligibility, benefit levels, or covered services, making oversight difficult and inequities inevitable.

Sixth and last, the proliferation of multiple payors for health care severely weakens the country’s monopsony power, or the ability of a single purchaser to negotiate fair prices for medicines, tests, and services. This structural weakness will inevitably drive up healthcare costs, harming not only indigent patients but all Filipinos.

These concerns go beyond any single budget cycle. They speak to the kind of health system we are choosing to build — one based on rules, equity, and dignity, or one dependent on individual discretion or patronage.

Dr. Antonio L. Dans, MD is a clinical epidemiologist and professor emeritus at the UP College of Medicine. He convenes the Sin Tax Coalition and the Healthcare Professionals Alliance against COVID-19 (HPAAC).