On the 12 June 2023, the National Assembly passed the National Health Insurance (NHI) Bill. The Bill was first introduced in 2009. There have been various engagements with the private sector to reach this point. One of the key purposes of the Bill is to establish a National Health Insurance Fund and to set out its powers, functions and governance structures for the NHI to provide primary health care to the country.
The NHI will be a mandatory state-run health insurance cover. Individuals that contribute to the pool may have access to the health services rendered by the private entities and the South African public health system for different levels of health care services which the Fund will purchase for all users who are registered with it. The aim of the National Health Insurance is to pool resources for the Fund from VAT and other collections such as general taxes, income contributions and monthly contributions from employees. The proposed NHI may result in medical schemes being gradually phased out and private Medical aids will only be able to provide complementary cover for services not listed in the NHI, as the intention is for the NHI framework to provide primary health care to South African citizens and other named persons. In the long term, medical scheme members may be pressed to abandon their current private medical cover, as it may become unaffordable to contribute to both the NHI and private medical aid schemes. As a result, Health Care Brokers who offer exclusively medical scheme products may face challenges in future and be forced to diversify their product offerings into other markets.
The Bill will be sent to the National Council of Provinces and then the President’s Office for approval.
In its current format, the proposed NHI roll-out is expected to take place in phases, with the first phase starting in 2023 until 2026, allowing for time to prepare systems, accrediting hospitals, and service providers, as well as finalising the Medical Schemes Amendment Act. Phase two will start after the completion of phase one and is envisioned to take a further 3 years.
For more information refer to https://www.parliament.gov.za/press-releases/press-release-national-assembly-passes-national-health-insurance-bill-and-land-court-bill