ZERO-BALANCE BILLING ONLY POSSIBLE WITH FULLY FUNDED PHILHEALTH – SEN. PIA CAYETANO

SENATOR Pia S. Cayetano stressed that the Zero-Balance Billing (ZBB) policy might just work as intended should the billions in legally earmarked PhilHealth funds be properly allocated to the agency.

“If PhilHealth were 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.

Her statement follows the Supreme Court’s ruling on the illegal transfer of P60 billion in PhilHealth funds to the National Treasury in 2024. Explaining her reservations during the third reading of the 2026 GAA, Cayetano said, “This is not a matter of an unfunded law. This is earmarked. So saan napunta ‘yun? What is clear is that the Sin Tax Reform Act of 2019 (RA 11346) 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.”

The senator said that while the Supreme Court’s ruling is a welcome correction, it also highlights a deeper problem: even with the ruling, much remains to be fixed both in the budget and in the way the budget is put together.

During the 2026 budget deliberations, she presented the deficits in sin tax allocations earmarked for PhilHealth from 2023 to 2026, amounting to ₱129.96 billion:

      –   2023: ₱83.9B was earmarked, only ₱79B appeared in the GAA (₱4.9B deficit)

       –  2024: ₱79.01B was earmarked, only ₱40.28B made it to the GAA (₱38.73B deficit)

        –  2025: ₱69.81B was earmarked, but the bicameral conference committee removed the allocation entirely (₱69.81B deficit)

         –   2026: ₱69.78B is earmarked, but only ₱53.26B is in the NEP (₱16.52B potential deficit)

Cayetano also pointed out that ₱106.95 billion in PCSO and PAGCOR revenues were legally intended for PhilHealth between 2019 and 2025, on top of the ₱60 billion covered by the Supreme Court ruling. “These gaps are not technicalities,” she said. “They are the reason ZBB has not become fully operational.”

PhilHealth has estimated that it needs at least ₱147 billion more to subsidize indirect contributors and achieve ZBB coverage 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,” she said. “If we want Zero-Balance Billing to work, we must restore every peso legally intended for the health of our people — and fix the process that keeps taking those pesos away.”