The king of Bahrain, Hamad bin Isa Al Khalifa, recently ratified the National Health Insurance Law (NHIL), Law No. 23 of 2018. The new law will provide universal basic health insurance coverage for all Bahrainis and residents. The NHIL is expected to be implemented in the beginning of 2019, six months after its publication in the official gazette.
Background
On 6 May 2018, the Shura Council in its session with the House of Representatives passed all 82 articles of the new law in three hours. The healthcare sector in Bahrain has heavily relied on government facilities and funding, but recent legislation is promoting a greater involvement of the private sector by allowing foreign private healthcare facilities, a shift that will be further strengthened by the NHIL. The government of Bahrain intends to decrease health sector expenses which are currently reaching 480 million dinars per year. Studies by the World Bank have shown that the new health care system provided by the NHIL could provide a saving of 200 million dinars by 2038.
Key details
The government of Bahrain intends to fund the national health insurance system from the national budget for coverage related to Bahrainis, spouses of Bahrainis, children of Bahraini mothers, Gulf Cooperation Council (GCC) nationals as well as the domestic workers they employ.
Financing for expatriates will initially come from new employer work permit fees, but later from payroll contributions to a national insurance fund. The new work permit fees and payroll contributions still need to be determined by the Supreme Council for Health.
Core coverage will include 19 categories of medical services. In the case of Bahrainis and GCC nationals, the services will be provided for free at government-owned facilities and at a maximum coinsurance of 40 percent if received at private facilities. Expatriates will be covered at 100 percent only for primary care, emergencies and a limited number of secondary medical services. They will have to contribute to the cost of the other 16 categories of medical care and services.
Foreign visitors will also be covered for emergency healthcare only, which will be funded through an increase in visa costs.
The coinsurance rates still need to be determined by the Supreme Council for Health. The new national health insurance law will likely increase the employment costs of expatriates in Bahrain who usually already enjoy supplemental health insurance provided by their employers. It is still unclear whether employers who already offer supplemental health insurance will have to bear the full cost of increased work permits fees and payroll contributions or whether there will be reduced rates or contracting out options.
Next steps
As stated by the President of the Supreme Council for Health, the new law might still have some discrepancies and is subject to further amendments to facilitate its implementation. Employers should monitor the implementation timeline of the new law and ensure compliance once the law enters into force.
