Abstract:The objective of this study was to investigate the role of health care affordability on health care equity in Makueni County, Kenya. The study was based on theory of inverse care law.The study applied cross-sectional survey and phenomenological research designs. Qualitative and quantitative techniques were used to design data collection methods. Yamane (1967) formula was used to get the sample size of 400 health care consumers.Purposive sampling technique was used to sample the health care managers and officials in the county health care workers and administrators. To sample the 400 universal health care consumers, proportionate stratified random sampling technique was used to get respondents from the three selected sub-counties (Kaiti, Kilome and Makueni Sub-Counties). Both structured and und unstructured Questionnaires were used to collect data from the beneficiaries of Universal Health Care using face to face method. Interviews were conducted with the county health department officials and the health care workers in public health care facilities.Findings from the study showed that the cost of health care services affected its distribution in the County. Policy makers were recommended to come up with policies which can equip health centers with enough resources i.e. human resource, supplies and capital in order to increase affordability and accessibility of health care. Key terms:Universal Health Care, affordability and health-care equity