The Healthcare Fund program was established in 2010 with the enactment of the National Healthcare Financing Act, RPPL 8-14, codified in Title 41, Chapter 9 of the Palau National Code.
Currently, the HCF Governing Committee consists of the Minister of Finance, the Minister of Health, the Administrator for the Social Security Administration, a Governor's Association representative and a Chamber of Commerce representative.
The HCF is Palau's first national healthcare financing program. It consists of two components, individual Medical Savings Accounts and a pooled universal social health insurance fund commonly known as National Health Insurance. These components are funded through mandatory contributions on earned income and collected in the same manner as contributions to the Social Security Trust Fund.
As a result of a push for healthcare reform, as voiced in a 2006 National Leadership Symposium, an Ad Hoc Committee on Healthcare - made up of representatives from the Ministry of Finance, Ministry of Health, Social Security Administration, as well as the private sector and the private health insurance sector - was formed and undertook the responsibility of developing healthcare legislation which would provide for and promote the health and social welfare of the citizens of the Republic of Palau.
The Ad Hoc Committee reviewed the availability and cost of medical services in Palau as well as several different systems of nationally provided healthcare systems throughout the world. After reviewing such healthcare systems, the Committee considered the healthcare system provided by the National Government of Singapore to be of the greatest value to Palau.
In 2007, the Ad Hoc Committee, which developed into the “Sustainable Healthcare Financing Steering Committee” spearheaded a two-phase project, which was financed by the Japan Special Fund through the Asian Development Bank , to carefully research and develop a healthcare-financing system to meet Palau’s healthcare needs and costs.
The result of the above was the successful drafting of legislation that eventually became the National Healthcare Financing Act, which was enacted into law on May 7, 2010. The HCF Program was successfully implemented on April 1, 2011.