KUALA LUMPUR, April 23 — Bukit Gasing state assemblyman Rajiv Rishyakaran has demanded unconditional coverage of pre-existing conditions under the government-designed base medical and health insurance/takaful (Base MHIT) product.
The DAP state lawmaker cited recent “teasers” by Bank Negara Malaysia (BNM) that coverage of pre-existing conditions might only apply to “stable” or “controlled” cases.
“This creates a dangerous grey area,” said Rajiv, who is also founding chairman of Socdem Malaysia, in a statement today.
“Socdem Malaysia believes that health care is a right, not a privilege reserved for the perfectly healthy. If the MHIT rollout continues to allow insurers to ‘cherry-pick’ the healthiest applicants while sidelining those with manageable chronic illnesses, it is not a ‘reform’—it is merely a rebranding of the status quo.
“We need a ‘No Look-Back’ provision that is absolute, not conditional.”
BNM governor Abdul Rasheed Ghaffour told Berita Harian recently that the Base MHIT plan would introduce a “no look-back clause” that prohibits insurance and takaful operators (ITOs) from denying claims based on pre-existing conditions after a certain period of continuous coverage.
Malaysiakini previously reported that the required continuous coverage to operate a “no look-back clause” could potentially be as long as 10 years.
Rajiv noted that for decades, the private health insurance market has “systematically excluded those who need it most”.
“Currently, Malaysians diagnosed with diabetes, hypertension, or heart complications are often flatly rejected or burdened with ‘prohibitive loading’ that makes premiums unaffordable,” said the Selangor state representative.
He urged BNM and the Ministry of Finance (MOF) to clarify what percentage of the adult population currently living with non-communicable diseases (NCDs) would qualify for Base MHIT coverage, amid Malaysia’s NCD crisis.
About one in five adults are living with diabetes and more than half of the country’s adult population are either overweight or obese. A third of Malaysian adults have hypertension.
“If the plan excludes those with ‘uncontrolled’ conditions, the government is essentially abandoning the most vulnerable segment of the M40 and B40,” said Rajiv.
He also asked what would be the maximum percentage a person with a pre-existing condition would be charged above the base rate of the Base MHIT that is risk-rated based on age and health status. “Without a strict cap, ‘coverage’ is just a paper promise if the price is triple the standard rate.
Rajiv further asked exactly when Malaysians could purchase the Base MHIT product, as the government has said that a “pilot” will begin in the second half of this year.
“We urge Finance Minister II Datuk Seri Amir Hamzah and the Governor of Bank Negara to come forward with the data: How many Malaysians will be left behind by the current MHIT framework?” he said.
“The people of Bukit Gasing and the wider Malaysian public deserve a health care financing system that offers a genuine safety net, not just another exclusionary financial product.”
