MANILA, Philippines — The 2026 national budget bars politicians from intervening in the delivery of health assistance to indigent patients, including the issuance of guarantee letters, Health Secretary Teodoro Herbosa said Wednesday.
Speaking at a Malacañang briefing, Herbosa said indigent patients admitted to Department of Health (DOH) hospitals no longer need guarantee letters from elected officials to access services under the DOH’s Zero Balance Billing (ZBB) program. He said the General Appropriations Act (GAA) for 2026 prohibits the use of guarantee letters in government hospitals for the Medical Assistance to Indigent and Financially Incapacitated Patients (Maifip) program starting this year.
“The law actually prohibits a guarantee letter,” Herbosa said. “The law is very clear and we will follow the law.”
Herbosa said the DOH will issue updated implementing rules and regulations for Maifip by February to comply with the “anti-epal” provision cited by President Ferdinand Marcos Jr. when he signed the 2026 GAA.
Under Section 19 of the GAA, cash assistance and other forms of financial aid must be distributed only by authorized government personnel or accredited partners. The law also bars elected officials, candidates, political parties, and their representatives from influencing or participating in the distribution of aid and prohibits political signage or branding at distribution sites.
Marcos said upon signing the budget that politicians would be barred from distributing financial aid to ensure assistance reaches beneficiaries without patronage.
Under the ZBB program, patients confined in basic or ward accommodations in DOH hospitals do not pay for medical services, medicines, or doctors’ professional fees. Herbosa said the program removes the need for patients to seek help from politicians for hospital expenses.
He clarified that patients may still seek assistance from elected officials, but guarantee letters issued by politicians are no longer required under ZBB. He added that patients may directly approach the DOH for assistance if they qualify and funds are available.
A guarantee letter is a document from a government official or agency assuring full or partial payment to a health service provider for a patient’s expenses.
Herbosa said guarantee letters remain valid until the DOH issues a new administrative order on Maifip. Under existing DOH rules, guarantee letters may still be used in private hospitals, local government-run facilities, and hospitals operated by state universities and colleges. He added that politicians may continue issuing guarantee letters but must cover expenses without using Maifip funds.
Maifip received P51.6 billion under the 2026 GAA, a 25-percent increase from P41.16 billion last year. The amount is comparable to the P53.13-billion government subsidy allocated to the Philippine Health Insurance Corp. this year.
Maifip began in 2014 as the Medical Assistance to Indigent Patients in Government Hospitals and was renamed in 2016. Some health advocates and lawmakers have raised concerns over its use through the guarantee letter system and its impact on the Universal Health Care program.
