Ramaphosa hits pause on NHI

The Office of the State Attorney has issued a notice on behalf of President Cyril Ramaphosa, wherein he undertakes not to promulgate any provisions of the controversial National Health Insurance (NHI) Act yet.

This will remain the case until the Constitutional Court (CC) has delivered its judgment on whether due process was followed prior to the Act’s ratification.

This notice was released on Friday, 20 February, and explains that the President has formally undertaken not to promulgate any provisions on the NHI Act until the CC has ruled on the specific “public participation challenges”.

This, the notice explains, is to ensure orderly legal conduct and avoid overlapping or parallel court proceedings.

The President’s undertaking follows a similar one made by Health Minister Aaron Motsoaledi on 19 February, whereby he agreed not to request the President to bring the NHI Act into effect pending the CC’s decision.

The specific public participation challenges causing this roadblock refer to two cases before the CC, one from the Board of Healthcare Funders and another from the Premier of the Western Cape. The CC will hear these challenges in early May 2026.

There are also presidential assent challenges before the court, though these cases will be postponed until the public participation challenges have been resolved.

Trade union Solidarity has celebrated this development, saying it means that NHI has been “placed on hold for the time being”. Solidarity is a party to one of approximately nine lawsuits filed against the NHI Act.

Solidarity Research Institute economic researcher Theuns du Boisson claimed this latest development clearly indicates that “sustained pressure from Solidarity and other parties is having the intended effect”.

“It is now time to maintain this pressure, and it provides the Department of Health with an opportunity to reconsider,” he said.

“It should, of course, never have progressed this far, as Solidarity has long indicated how unworkable, irrational and unaffordable the NHI scheme is.” 

“Even the Treasury recognises this, and we hope that this realisation is now also reaching the president and the minister of health.”

As part of its crusade against the government’s NHI scheme, Solidarity has also put forth its own alternative to the NHI Act, named the Healthcare Funding Reform Bill, which was tabled in Parliament last year.

“There is a viable alternative to consider, rather than destroying the lives of millions of South Africans through the NHI,” Du Boisson said.

“Now is the time for the country’s leaders to exercise sober judgment and to consider proposals such as our alternative Bill.” Du Boisson urged the government to abandon the NHI.

Solidarity will also appear in court again next week when the case concerning the consolidation of various court cases against the government over the NHI is scheduled to be heard.