Kenya’s president has dismissed claims that billions of shillings were lost from the country’s new national health insurance programme, calling the reports misleading and politically charged.

Speaking during a joint parliamentary meeting between members of the United Democratic Alliance and the Orange Democratic Movement, William Ruto said suggestions that the government had lost Sh50 billion from the Social Health Insurance Fund were inaccurate.

“Forget about the propaganda in the headline of the news that we lost some Sh50 billion,” Mr Ruto told lawmakers. “If we lost Sh50 billion, it means there would be nothing to pay hospitals.”

The president said hospitals across the country were continuing to receive payments under the new health system, adding that about Sh16.2 billion had been disbursed this week alone for primary healthcare and insurance-covered services.

Audit raises questions

Mr Ruto’s remarks came in response to a recent audit report by Nancy Gathungu, which highlighted irregular claims within the health insurance system.

The review, covering the period between July 2024 and June 2025, raised concerns about billing records submitted by some healthcare providers.

Among the examples cited were cases where facilities reportedly claimed multiple complex procedures for the same patient on the same day.

In one instance, the audit said claims suggested a patient had undergone four open-heart surgeries in a single day, an occurrence recorded more than 3,000 times and costing roughly Sh445 million.

The report also flagged maternity claims showing the same patient listed as delivering several times within a year.

Such patterns, the audit said, indicated possible weaknesses in billing oversight and verification processes.

Government response

Government officials insist the system is designed to detect such anomalies before payments are made.

Aden Duale has previously said the digital claims system used by the Social Health Authority flags suspicious claims for review before funds are released.

According to the health ministry, about Sh12.7 billion in fraudulent or irregular claims had already been identified and rejected through the verification process earlier this year.

Officials say the system was built specifically to detect medically unlikely claims and prevent improper payments.

Expanding health coverage

The dispute comes as the government presses ahead with sweeping health reforms aimed at expanding access to care.

The Social Health Insurance Fund replaced the former national insurance system and forms a central part of Kenya’s push toward universal health coverage.

Government data shows that by late February this year, roughly 29.7 million people had registered under the scheme.

During the same period, the Social Health Authority reported collecting about Sh142.78 billion in contributions and paying more than Sh105 billion to healthcare providers.

Mr Ruto said the reforms are intended to reduce the financial burden of healthcare on Kenyan families.

“We are paying the highest amounts of money to hospitals that have ever been paid under any administration or programme,” he said. “We are dealing with health to reduce the bills paid by citizens.”

The debate over the audit findings, however, is likely to continue as lawmakers and oversight bodies examine how the new system handles claims and public funds.