People who will not have paid all the required contributions to the community-based health insurance scheme (Mutuelle de Santé) by December 31 of each year, will be charged a fine, according to a new legislation in the offing. Imposing the fine is provided for in the new draft law amending the 2015 law governing the organisation of the community-based health insurance scheme, whose relevance was approved by a plenary session of the Lower Chamber of Parliament on Wednesday July 29. Presenting the new bill, Uzziel Ndagijimana, the Minister of Finance and Economic Planning told lawmakers that the extra fee imposed beyond December 31, is intended to encourage people to pay contributions on time. Among changes that the bill is bringing about include the removal of at least 30 days that a person who has paid their premium to Mutuelle de Santé should wait before being entitled to medical services under this health scheme. The law will also generally ease the way the subscribers are given access to healthcare, where for instance, whoever will have paid 50 percent of the required contribution, will be able to get medical services. Under the current law, Mutuelle de Santé affiliates are only entitled to health services when they have fulfilled all the covered all the required contributions and have to wait for a 30 days after paying to be able to get those services. MP Elisabeth Mukamana said that the fine should be based on justifiable factors. “A person might delay or fail to pay the required contributions because of various reasons including lack of financial means. So, the underlying reasons should be considered,” she said. However, MP Eugene Mussolini said that fining people who do not meet the deadline for the payment of insurance premiums is not a problem, because when insurance body runs out of money people cannot expect treatment. Minister Ndagijimimana explained that everything must be done to ensure pay on time because such delays affect the schemes operations, which ends up victimizing those that paid on time. “Members of a household who have not paid all the contribution on December 31, will have to pay such contribution plus a fee that will be determined by a Prime Minister’s order,” he said. “That additional cost is a way that can try to make people pay contributions within the set deadline so that we do not have many people who pay health insurance premiums when they have become ill.” Call for better services Meanwhile, MP Mussolini shared the same concern with other MPs that there are drugs and other medical services that are not covered under Mutuelle de Santé, which is a serious issue to its subscribers. “People with disability, including children who need prostheses (artificial body parts), do not get them under Mutuelle de Santé. What is worse is that there are also children who are born with abnormal body organs, but devices to correct them so as to protect them from disability are not covered by the scheme. That issue should be addressed,” he said. Mussoline represents people with disability in parliament. Ndagijimana said that Mutuelle de Santé has been underfunded, reiterating that it owes Rwf20 billion in outstanding bills for services offered to its affiliates by health facilities in the 2019/2020 fiscal year, an issue he said is to blame for limited healthcare the affiliates to the affiliates receive. Meanwhile, he said reassured parliamentarians that the new subisidies to the scheme will ease the problem and help its members get needed medication. About the Mutuelle Majority of Rwandans contribute Rwf3,000 for each family member to access medical services for the whole year while those from vulnerable families are paid for by government through existing social protection mechanisms. The scheme which operates under Rwanda Social Security Board (RSSB) caters for over 80 per cent of the population.
