Government gears up for NHI battle  

The government is ready to defend its National Health Insurance (NHI) scheme in court against challenges levelled by business groups and political parties calling the NHI Act unconstitutional.

President Cyril Ramaphosa signed the NHI Bill into law on Wednesday, 15 May, just two weeks before the country’s national elections, where his party is expected to lose its majority. 

The scheme aims to transform South Africa’s healthcare system to achieve universal coverage for health services and, through this, overcome critical socio-economic imbalances and inequities of the past. 

The legislation provides a framework for the provision of universal care through a state-run fund and will ban the private sector from financing treatment covered under the plan. 

While the government has promised that the signing of the NHI into law will result in universal healthcare free at the point of delivery, this ambition is far from reality. 

Business groups, such as Business for South Africa (B4SA), have said the NHI, as proposed, has no practical funding model, does not pass Constitutional muster, and will be tied up in the courts. 

Business Unity South Africa CEO Cas Coovadia said that, in response to the NHI becoming law, the organisation would consider its options, including legal action. 

“Our subsequent actions will be guided by our belief that it is essential that we get the NHI right through all means still at our disposal, including appropriate legal interventions,” Coovadia said. 

Trade union Solidarity has already taken the National Department of Health to court once before over the NHI late last year and has promised to challenge it by all means necessary. 

South Africa’s main opposition party, the Democratic Alliance, has also said it would take the government to court over the implementation of the NHI. 

Minister of Health Joe Phaahla has said the government is ready to defend the NHI in court and understands that some corners of South Africa are willing to engage in ‘lawfare’ to prevent the scheme from being implemented. 

He said the threats of legal action are nothing new as throughout the Parliamentary process business groups, civil society, political parties, and trade unions threatened legal action. 

“We will be ready to engage with aggrieved parties in the courts, but our hope is that we will be able to begin implementing the Act as soon as possible,” he told Newzroom Afrika. 

The government has acknowledged that the NHI is open to legal challenges and that, in a constitutional democracy, individuals and groups can engage in lawfare. 

“It is not surprising that there have been legal threats, and we should acknowledge that they are allowed to challenge it,” Phaahla said. 

The minister is confident that despite the looming legal challenges, his department will be able to follow the two-step implementation process of the NHI.