Senate Committee on Finance Chair Sherwin “Win” Gatchalian admitted that lawmakers still maintain the power to issue guarantee letters (GL) for the provision of medical assistance, amid reservations surrounding “ayuda” or short-term aid due to deeply-embedded patronage politics.

This is in connection with the Department of Health’s (DOH) Medical Assistance to Indigents and Financially Incapacitated Patients (MAIFIP) Program, whose allocated funds grew in the 2026 national budget, reported RH 28 Raymund Dadpaas.

Gatchalian explained that, since no law had created the practice of providing GLs, the DOH may abolish it by devising a new set of guidelines.

Even his fellow senators, he disclosed, had asked him whether the practice would be discontinued. During the bicameral conference committee deliberations, the Senate contingent pushed for the removal of this practice under the Anti-Epal provision.

“‘Yung GL is part of the DOH process. So kung tatanggalin ‘yan, DOH na ang magtanggal niyan. Kaya nilang tanggalin ‘yan, ‘di na kailangan ng batas iyan, e. In fact, wala namang batas creating the GL, it’s their guidelines that created the GL. So kung gusto tanggalin ng DOH, puwede naman tanggalin. Kung puwedeng i-reform para mas mabilis ibigay sa tao, mas puwede rin ‘yun. Para sa’kin, importante, natutulungan ang tao,” the committee chairperson said.

For Sen. JV Ejercito, a health advocate, it would be better to pour the MAIFIP funds into PhilHealth instead, enabling the agency to implement the promised zero-balance billing program. This way, the sick will not have to fall in line at politicians’ offices to secure a GL. Instead, they may go straight to the hospitals to receive treatment, free of charge.

The MAIFIP’s large allocation was the reason Ejercito had reservations about the General Appropriations Bill (GAB), despite having voted in favor of it.

The Senate ratified the 2026 GAB on Monday, December 29, and promptly transmitted it to President Ferdinand Marcos Jr. for signing.