The health sector is the largest service devolved to local government units (LGUs) by Republic Act No. 7160 or the Local Government Code (LGC) of 1991. However, devolution has not automatically improved health service delivery and made services accessible across LGUs. Health human resources, budget, and facilities are spread unevenly across the country, with Metro Manila or the National Capital Region (NCR) and other centers having more of these. Because NCR has many advanced health facilities, most case studies on health services and devolution focus on rural areas where services are very basic and limited. However, NCR also experiences uneven access to health services. Thus, it is important to look at NCR’s health situation and access to services and discuss possible institutional and other reforms, especially with the current national administration’s proposals to initially revise and now amend the 1987 Philippine Constitution. It is also important in the context of NCR’s LGUs currently dealing with COVID-19 and its consequences, especially for vulnerable sectors. This policy brief utilizes the human security approach and relies on available assessments of the situation and access to health services in NCR.