President Cyril Ramaphosa has agreed to delay the proclamation of any sections of the National Health Insurance Act following multiple legal challenges before the Constitutional Court.
The decision was taken after consultations between Ramaphosa and Health Minister Dr Aaron Motsoaledi in light of litigation initiated by various parties against the president and the minister.
The proclamation will be delayed until the Constitutional Court hands down its judgments in challenges due to be heard from 5 to 7 May, according to a statement released by the Presidency on Tuesday.
The matters scheduled for hearing relate to the public participation process that preceded Parliament’s adoption of the NHI Bill.
The undertaking to delay proclamation will remain in place until the Constitutional Court delivers its judgments. The agreement is expected to be made an order of court on 24 February.
The NHI Act, signed into law in May 2024, aims to create a single, state-run fund that will provide universal healthcare free at the point of delivery. The legislation seeks to replace South Africa’s current two-tier health system, which sees wealthier citizens accessing private healthcare whilst the majority rely on underfunded public facilities.
However, the Act has faced significant opposition since its passage. At least five formal legal challenges have been lodged by organisations including the South African Medical Association, the Health Funders Association, the Free Market Foundation, the Board of Health Care Funders and the Democratic Alliance.
Opponents argue the Act is constitutionally flawed, financially unsustainable and would eliminate private medical schemes. The Health Funders Association has described the NHI model as “unaffordable, unworkable and unconstitutional”, claiming it would require tax increases far beyond South Africa’s fiscal capacity.
The Presidency said the delay will not affect the broader timetable for implementing the NHI. The Department of Health indicated that preparatory work, including efforts to strengthen and improve health services, is ongoing before any sections of the Act are brought into operation.
Government reaffirmed its commitment to the National Health Insurance policy, stating it will continue to act within the requirements of the law and respect the judicial process to ensure that implementation proceeds without undue delay.
The Department of Health will continue fulfilling its constitutional responsibility to strengthen the health system and improve the quality of care for all South Africans.
