KATHMANDU: Prime Minister Sushila Karki has expressed serious concern over a funding shortfall in Nepal’s national health insurance program, which covers more than 10 million people, nearly one-third of the population.

Summoning Health and Population Minister Dr Sudha Gautam and senior officials, Karki warned that suspending the program would deprive hundreds of thousands of low-income citizens of essential treatment.

According to the Health Insurance Board, several hospitals, including Tribhuvan University Teaching Hospital, have stopped providing services under the scheme since January 15 due to unpaid dues.

TU Teaching Hospital alone cites pending payments of around Rs400 million, rejected claims, and low service rates as key problems. Many insured patients are now returning without treatment or paying out of pocket.

The board says Rs 14 billion has already been paid to health facilities, but an additional Rs 10.5 billion is required to clear dues to more than 500 hospitals. Officials attribute the delay to a funding crunch rather than administrative lapses.

The government has pledged to release funds, but they are yet to be disbursed. Meanwhile, a new cap limiting outpatient coverage to Rs 25,000 per patient will take effect on February 13, raising concerns among health experts about its impact on access and policy renewal.