The suspension of medical insurance cover has triggered widespread suffering among police officers and teachers in Kenya, with hospitals denying services due to delayed capitation. The crisis, affecting over one million teachers, police officers, and their dependents, stems from the government's failure to remit payments to contracted hospitals. These facilities are owed Sh11 billion for teachers' cover alone, leaving 403,522 tutors and 969,638 dependents in a precarious situation. Similarly, the medical schemes for over 110,000 police officers and their dependents under the National Police Service (NPS) and Kenya Prisons Service are reportedly dysfunctional.

Several hospitals have already suspended services to teachers under the Teachers Service Commission (TSC) medical scheme. Tenwek Hospital in Bomet County, for instance, ceased offering medical services on credit from February 1. Other affected hospitals include Kisii Referral Hospital and Reale Hospital in Uasin Gishu County. These institutions cite non-payment by the defunct National Hospital Insurance Fund, its successor Social Health Authority, and Medical Administrators Kenya Limited, which manages the teachers' medical scheme through Minet Kenya, as the primary reason for their actions.

While some hospitals have issued official notices, teachers report that others are denying treatment without prior warning, despite contractual obligations requiring a seven-day notice before suspension of services. Minet Kenya, which oversees approximately 600 medical providers nationwide, acknowledges the issue and states it is collaborating with the government to resolve the outstanding balance. CEO Sammy Muthui attributed the problem to cash flow issues affecting various sectors in the country, noting that progress has been made in negotiations with TSC to offset the debt.

Police officers, whose medical scheme is now managed by APA Insurance after a transition from CIC Insurance in April of the previous year, are also facing dire circumstances. One officer with a chronic condition recounted being told to wait two weeks for a consultation at Nairobi West Hospital, highlighting the absurdity of expecting illness to adhere to such timelines. The situation is particularly acute for officers stationed in remote areas, as illustrated by an officer in Lamu whose wife was denied treatment, forcing them to pay out of pocket.

The Kenya National Union of Teachers (KNUT) and the Kenya Union of Post Primary Education Teachers (KUPPET) have both voiced concerns that the crisis could disrupt learning. KNUT Secretary-General Collins Oyuu emphasized the indignity suffered by teachers, especially those with chronic illnesses, and demanded a clear plan from the government to settle the outstanding debts and ensure teachers receive the medical services they are entitled to. KUPPET acting secretary general Moses Nthurima echoed these sentiments, calling for immediate intervention from the Treasury Cabinet Secretary John Mbadi.

Frustrations among police officers have reached a critical point, raising fears of potential unrest. A widely circulated video captured a heated exchange between a junior and a senior officer during a meeting addressing the insurance issue, with the junior officer accusing the administration of neglecting their plight. Many officers are advocating for the elimination of third-party brokers from the medical cover arrangement, believing that direct hospital-insurer relationships would be more effective.

The teachers’ medical scheme, established in 2015, replaced a direct medical allowance and provides teachers and their dependents with a range of services, including outpatient, inpatient, maternity, dental, optical, psychiatric, and counselling services, as well as evacuation, funeral benefits, and international referrals. However, the government’s failure to remit payments has led to the denial of these essential services, leaving teachers in a vulnerable position. Unions and police representatives are united in their call for immediate action from the Treasury, warning of severe consequences if the situation is not promptly addressed. Nthurima asserted that delaying teachers' access to medical care is a violation of their rights and undermines their ability to be productive in the classroom.