Politicians are barred from directly intervening in the delivery of health assistance to indigent patients, including through guarantee letters (GLs), under the 2026 national budget, Health Secretary Teodoro Herbosa said Wednesday, January 7.
Speaking at Malacañang, Herbosa said patients no longer need GLs from senators, congressmen, or other officials to access services under the Department of Health’s Zero Balance Billing (ZBB) Program, which covers medical fees, medicines, and professional fees for those confined in basic or ward accommodations.
GLs banned in government hospitals
The 2026 General Appropriations Act (GAA) prohibits GLs in government hospitals for the Medical Assistance to Indigent and Financially Incapacitated Patients (Maifip) program. Section 19 of the law requires all financial aid to be distributed exclusively by authorized government personnel or accredited partners, banning politicians from participating or influencing the process and prohibiting political branding at distribution sites.
“The law actually prohibits a guarantee letter. The law is very clear and we will follow it,” Herbosa said. President Ferdinand Marcos Jr. also warned that politicians would be barred from distributing aid to ensure support reaches beneficiaries without patronage.
New Maifip rules coming by February
Herbosa said DOH will issue updated rules for Maifip by February. GLs will still be honored until a new administrative order takes effect, particularly in private hospitals, local government facilities, and state universities. Politicians may still issue GLs, but must shoulder costs themselves, without using Maifip funds.
Patients can still seek help from elected officials, but GLs are no longer necessary under ZBB. “They can go straight to the Department of Health and we will help them if they are qualified and if funds are available,” Herbosa said.
Debate continues over Maifip
Maifip received P51.6 billion under the 2026 GAA, up 25% from last year, nearly matching PhilHealth’s P53.13-billion subsidy. Critics argue the fund has fueled patronage politics through GLs, while Senator JV Ejercito, author of the Universal Health Care law, has called for its gradual phaseout.
Patient advocate Rey Abacan Jr., founder of Dialysis PH Support Group, said GLs were essential but humiliating to secure. “You are already sick, but you still have to beg,” he said, urging the government to strengthen PhilHealth coverage before fully removing guarantee letters.
