Senator Villanueva calls for revamp of PH autism spectrum disorder benefit package

Senator Joel Villanueva has urged the Department of Health (DOH) and the Philippine Health Insurance Corporation (PhilHealth) to revamp the government’s autism spectrum disorder (ASD) benefit package, pointing out its dismal utilization rate since launching in 2017.

During a Senate budget hearing on the proposed 2027 appropriations for the DOH and PhilHealth, Villanueva questioned whether the ₱74.45-billion National Health Insurance Program subsidy would adequately reach Filipinos with ASD and other developmental conditions.

“A promise on paper is not the same as help in hand. In eight years, this benefit has reached only 482 families,” Villanueva said. “We appreciate PhilHealth’s commitment today, and we don’t have to wait for a new law to start closing that gap.”

PhilHealth President and CEO Dr. Beverly Lorraine C. Ho acknowledged the low uptake, revealing that only 482 claims have been paid nationwide over eight years. She attributed the low volume primarily to a severe shortage of accredited providers, noting that only five facilities in the country are currently authorized to deliver the service.

Villanueva also challenged the adequacy of the current benefit structure. While the package covers up to 90 therapy sessions, its diagnostic assessment payout ranges between just ₱3,000 and ₱5,000—a fraction of the actual cost families incur when seeking an official autism diagnosis.

The senator highlighted Senate Bill No. 1822 (the National Autism Care, Support, and Inclusion Act)—which passed third and final reading in the Senate last March—as a long-term solution to broaden PhilHealth coverage for persons with ASD.

In response, Ho said PhilHealth is finalizing an updated policy slated for release before the end of the year. Following a directive from the President’s recent State of the Nation Address, the revised package will double both the benefit rates and the number of covered consultations.

To address provider shortages, PhilHealth is revising its accreditation guidelines to allow occupational and speech therapists to qualify based on professional licensure rather than requiring a dedicated physical clinic. The agency is also expanding a screening and training program for barangay health workers and daycare personnel in partnership with the Developmental Pediatrics Society.

Villanueva further pressed Health Secretary Edwin Mercado on the nationwide deficit of speech-language pathologists, occupational therapists, and physical therapists, asking how many positions would be funded under the DOH’s 2027 health worker deployment strategy.

Mercado explained that training these specialists takes four to five years and that many graduates migrate abroad for better compensation. He noted that expanding PhilHealth coverage and improving professional fees could incentivize more specialists to remain in the Philippines.

“A law on paper does not put a therapist in a clinic. If we don’t make it worthwhile for our own graduates to stay and practice here, families will keep waiting no matter how many laws we pass,” Villanueva said. “We’re ready to work with DOH, PhilHealth, and our schools to change that.”

Villanueva affirmed that his office will coordinate with PhilHealth and the DOH on interim solutions while the House of Representatives deliberates on its counterpart bill.