Why Teachers Could Lose Access To Healthcare From May, TSC Warns

The Teachers Service Commission (TSC) has issued a stark warning over the future of healthcare access for teachers across the country, revealing that more than 400,000 educators and close to one million of their dependants risk losing medical coverage as early as May.

The looming crisis stems from a persistent funding shortfall affecting their medical scheme, now administered under the Social Health Authority (SHA). While appearing before the National Assembly’s education committee earlier this week, TSC Acting Chief Executive Officer Evarleen Mitei painted a concerning picture of the situation.

She disclosed that the commission had initially requested KSh 26.5 billion to adequately cater for the teachers’ comprehensive medical cover.

However, only KSh 16.5 billion was approved and allocated, leaving a substantial deficit of KSh 10 billion. According to Mitei, this gap has significantly strained the system and threatens the continuity of healthcare services for teachers nationwide.

The committee session, chaired by Tinderet Member of Parliament Julius Melly, also heard that the number of beneficiaries under the scheme continues to grow steadily. Initially, the program onboarded approximately 400,000 teachers along with one million dependants.

However, ongoing recruitment within the education sector has steadily pushed these numbers higher, placing even more pressure on the already underfunded scheme.

The current situation traces back to December 2025, when teachers were transitioned from the Minet Insurance scheme to the SHA framework.

This shift followed a series of negotiations involving key stakeholders, including the Kenya National Union of Teachers (KNUT), the Kenya Union of Post-Primary Education Teachers (KUPPET), the TSC, and the Ministry of Health. The transition marked a major policy change in how teachers’ healthcare would be managed and financed.

However, the move was not without resistance. Union representatives initially expressed strong reservations about joining SHA, citing fears over the potential erosion of benefits that teachers had previously enjoyed.

Among their concerns were reduced coverage for chronic illnesses, possible exclusion from certain private healthcare facilities, and an overall decline in the comprehensiveness of the medical package.

In an effort to allay these fears, Health Cabinet Secretary Aden Duale stepped in and assured stakeholders that the new system would enhance service delivery rather than undermine it.

He promised that healthcare services would remain uninterrupted and even improve under the SHA framework. His intervention ultimately played a key role in convincing unions to accept the transition.

Despite these assurances, developments in the months since the rollout have raised serious concerns. Four months into the new system, a growing number of teachers have come forward with complaints about their experiences under SHA.

Reports have emerged of teachers being turned away from hospitals due to unpaid bills, highlighting operational and financial challenges within the scheme.

Mitei attributed these issues primarily to the funding gap and delays in reimbursing healthcare providers. She warned that if hospitals continue to face prolonged delays in receiving payments from the insurer, they may be forced to deny services altogether, further exacerbating the crisis.

“If hospitals continue to experience delays in reimbursements from the insurer, then services could be disrupted,” she cautioned during her presentation to the committee.

Further compounding the issue, Mitei revealed that for the first seven months of operating under SHA, the commission required KSh 8.9 billion to sustain the teachers’ medical cover. However, only KSh 7.5 billion was received through a supplementary allocation, leaving an additional shortfall of KSh 1.4 billion.

This gap has contributed directly to the mounting unpaid claims and the frustrations being reported by teachers across the country.

As the situation unfolds, pressure is mounting on the government to address the funding deficit and stabilize the scheme before the looming May deadline.

Without urgent intervention, the risk of widespread disruption to healthcare services for hundreds of thousands of teachers and their families remains alarmingly high.

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