President Ferdinand Marcos, Jr. is set to deliver his fifth and penultimate State of the Nation Address (SONA) today. After the address, he is expected to submit the 2027 National Expenditure Program (NEP) to Congress, the executive branch’s proposed national budget that lawmakers will review, amend, and approve through the annual appropriations process.

Petitioners who brought a Supreme Court case challenging the zero-budget allocation for the Philippine Health Insurance Corp. (PhilHealth) in the 2025 budget are urging President Marcos to ensure that the proposed 2027 NEP for PhilHealth fully respects and complies with the Universal Health Care (UHC) Act, the Philippine Constitution, and the Sin Tax Reform Laws.

The petitioners include groups such as Social Watch Philippines, the Medical Action Group, Sentro ng mga Nagkakaisa at Progresibong Manggagawa, and Likhaan Center for Women’s Health, as well as individual petitioners including Jaime Galvez Tan and Fabian Dayrit.

The Supreme Court has yet to schedule hearings on several cases filed against what the petitioners describe as PhilHealth’s unlawful zero-budget allocation in 2025, even though the advocacy groups filed their petition more than one year ago.

Despite what health advocates describe as the government’s betrayal of the Filipino people and its failure to uphold its mandate to fund universal healthcare in the 2025 budget, they say severe underfunding of universal healthcare continues. The UHC Act made PhilHealth central to the country’s health financing system by seeking to enroll all Filipinos and expand access to needed health services, with government subsidies covering premiums for indirect contributors such as those who are not formally employed or able to pay regular premiums.

Last year, the Executive budget allocated only one-fifth of PhilHealth’s required budget for 2026 to provide universal healthcare for all Filipinos. Advocates say this amount will not be enough to cover rising benefit payments, which are expected to reach P400 billion this year, as PhilHealth President and Chief Executive Officer Dr. Edwin Mercado earlier announced to the media.

The petitioners are calling on the President and, subsequently, Congress to provide full appropriations for PhilHealth’s actual funding requirements. Specifically, they said this means honoring PhilHealth’s original proposal of P376 billion, which the state insurer submitted during the technical budget hearings for the NEP.

Health advocates are also urging President Marcos Jr. and Congress to reject any proposal that would introduce discriminatory or differential benefits between direct and indirect contributors, a policy direction they say Executive Secretary Ralph Recto is proposing.

They argue that UHC is grounded in social solidarity: the healthy support the sick, higher earners help those who earn less, and younger generations stand with older citizens who have contributed to society throughout their lives. Under this principle, every PhilHealth member contributes to a common fund intended to protect all Filipinos equally.

The advocates said the government’s need to encourage direct contributors to pay their PhilHealth dues would not have become as urgent if the government itself had fulfilled its side of the social contract embedded in Universal Healthcare by providing the legally mandated subsidized premiums for indirect contributors. Sin tax revenues are also part of the legal framework for financing health programs, making the annual budget debate a key test of whether those funds are being aligned with universal healthcare commitments.

Their urgent appeal is for the government to increase the national budget allocation for PhilHealth so it can meaningfully expand benefit packages, guided by transparent Health Technology Assessment, and make quality healthcare accessible to all Filipinos rather than only a select few.

Alce Quitalig is the senior budget specialist at Social Watch Philippines.