In order to deliver on its commitment to achieve universal health coverage (UHC), the Kenyan government is pursuing a policy of de facto privatisation that risks Kenyans’ right to health, deliberately expanding the role of the private sector while simultaneously neglecting the public one. New data on NHIF expenditure shows how payment to the private sector has skyrocketed. Between 2010 and 2021, NHIF payouts to the for-profit private healthcare sector rose more than 30-fold, vastly outstripping increases for public facilities (8.8 times). The embrace of private facilities via the NHIF is part of a broader push to get private actors into the business of healthcare, amounting to de facto privatisation. This approach is embedded in key national policies that seek to expand the role of the private sector in health. In his speech announcing his pledge to achieve UHC, President Kenyatta affirmed this goal, while high-level officials promote the health sector as an investment opportunity. Kenya’s approach has taken place at the urging and encouragement of key development actors including the World Bank, private foundations and wealthy countries seeking new markets. Healthcare is a big business, and foreign private equity firms and multinational corporations are eager to expand their footprint in Kenya.