Crisis Deepens in Nepal’s Health Insurance Program as Enrollment Assistants Launch Nationwide Pen-Down Strike

Kathmandu — Health insurance enrollment assistants across Nepal have launched an indefinite pen-down strike, saying long-standing problems within the national health insurance program remain unresolved and accusing the government and the Health Insurance Board of ignoring their concerns.

The protest threatens to disrupt services nationwide as enrollment workers halt their duties in protest against what they describe as systemic failures and lack of institutional recognition.

According to a press statement issued by the enrollment assistants, the health insurance program has struggled to function effectively, creating difficulties not only for insured citizens but also for personnel working directly within the system. The workers say they have spent years traveling door-to-door and village-to-village encouraging citizens to enroll in the program, yet their role has still not been formally acknowledged by the state.

The enrollment assistants identified seven major problems within the health insurance system. They claim weak financial management by the government and the Health Insurance Board has undermined the program, leading to delays in service delivery, shortages of medicines and healthcare facilities, and slow reimbursement of insurance claims.

They also pointed to policy uncertainty, inconsistent implementation, and weak grievance-handling mechanisms for service users. In addition, the workers accused the government and the Health Insurance Board of discriminatory treatment toward enrollment assistants despite their continued service under difficult conditions.

The protesting workers say they have continued operating with limited resources, insecure working environments, and minimal incentives, yet their contributions still lack formal institutional recognition.

Alongside the strike, the enrollment assistants have put forward a seven-point demand charter. Their demands include formal legal and institutional recognition of enrollment assistants, official classification as “health insurance facilitators,” and provision of appropriate salaries, benefits, and workplace protections based on workload and responsibilities.

They are also demanding that at least 20 percent of collected contribution amounts be allocated as incentive payments. In addition, they have called for immediate reforms to address existing weaknesses in the health insurance program and timely disbursement of incentive payments owed to enrollment workers.

The protesters have further demanded that health insurance services be made available in both public and private hospitals without restriction. They are also calling for the removal of the NPR 25,000 outpatient treatment ceiling and for the government to reverse its decision restricting non-emergency treatment services in private hospitals under the insurance scheme.

The enrollment assistants warned that the nationwide pen-down protest will continue until their demands are addressed. They have urged the government, the Health Insurance Board, and other concerned authorities to immediately begin dialogue, saying they remain open to resolving the dispute through negotiations.