More than 400,000 teachers and one million of their dependants’ risk losing access to healthcare after the Teachers Service Commission (TSC) disclosed a Sh10 billion shortfall in funding for its medical insurance scheme under the Social Health Authority (SHA).
Acting TSC Chief Executive Officer Eveleen Mitei told the National Assembly Education Committee, chaired by Tinderet MP Julius Melly on Tuesday, that the Commission had been allocated Sh16.5 billion for teachers' medical cover but required Sh26.5 billion, leaving a gap that could force hospitals to turn away educators.
"We have onboarded more than 400,000 teachers and one million dependants into the SHA scheme. However, the cost of providing adequate health services to all members continues to rise as we employ more teachers," said Mitei.
The shortfall deepens a crisis that predates the transition from the previous Minet insurance scheme to SHA, which took effect on December 1, 2025. As at December 31, 2025, the TSC said it carried an outstanding bill of Sh7.448 billion under Minet, a figure presented as attributed fact before the committee but not independently verified.
For the current seven-month period under SHA, Mitei said the Commission required Sh8.9 billion but accessed only Sh7.5 billion through a supplementary allocation, leaving a Sh1.4 billion gap for that period alone.
"The shortfall could affect service delivery, particularly if hospitals experience delays in reimbursements from the insurer," the Commission noted.
Teachers' unions say the warning is not new. Officials from the Kenya National Union of Teachers (KNUT) and the Kenya Union of Post Primary Education Teachers (KUPPET) have long criticised the design and implementation of teachers' medical cover.
"Teachers have on many occasions been turned away from hospitals because of unpaid bills.
A medical scheme is only as good as its reliability, and for years, that reliability has been in question," a union official said.
The government released Sh4 billion to hospitals in March to settle claims covering December 2025 to February 2026, following high-level talks between Health Cabinet Secretary Aden Duale, the TSC and KUPPET.
The programme covers 413,577 teachers and 807,426 dependants under the Mwalimu Comprehensive Medical Cover.
The government also clarified that the teachers' Group Life Cover and benefits under the Work Injury Benefits Act are not administered under SHA, leaving TSC to seek separate funding from the National Treasury.
MPs scrutinising TSC's Supplementary Estimates I for the 2025/26 financial year expressed concern that continued underfunding could undermine teacher morale.
Some warned that without a sustainable financing model, SHA risks replicating the failures of the Minet scheme.
The Commission confirmed it made its first withdrawal under Article 223 of the Constitution on March 5, 2026, to settle payments owed to SHA, a move aimed at preventing an immediate disruption of services.
TSC plans to recruit 16,000 additional teachers for junior and senior schools in the 2026/27 financial year at a cost of Sh1.9 billion, as part of efforts to address a nationwide teacher shortage of approximately 116,000.
The Education Committee is expected to table its report on the sector's budget before the House in the coming weeks.
