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NATIONAL HEALTH INSURANCE ACT GAZETTED
- 16 May 2024
- New Legislation
- SA Legal Academy
The National Health Insurance Act has been gazetted but is not yet in force. It provides for the establishment of a national health insurance fund in which ‘allocated resources’ will be pooled for the purpose of procuring ‘health care services, medicines, health goods and health-related products from certified and accredited health care service providers, health establishments and suppliers’.
Subject to section 57 (transitional arrangements) ‘different dates may be fixed in respect of the coming into effect of (the Act’s) different provisions.’
Section 57 provides that:
- the Act ‘must be implemented over two phases’,and that
- ‘National Health Insurance must be gradually phased in using a progressive and programmatic approach based on financial resource availability’
To that end, Phase 1 (a period of four years from 2023 to 2026) must:
- continue implementing ‘health system strengthening initiatives’ (including human resources alignment with Fund user requirements)
- ‘include the development of National Health Insurance legislation and amendments to other legislation’
- include undertaking initiatives aimed at establishing institutions necessary for ‘a fully functional Fund’
- include purchasing personal health care services for vulnerable groups (referring expressly to children, women, people with disabilities and the elderly), and
- prepare for establishing the Fund as a Schedule 3A entity (including developing and implementing administrative and personnel related arrangements).
Phase 2 (a period of three years from 2026 to 2028) must include
- continuing health system strengthening initiatives
- mobilising ‘additional resources where necessary’, and
- selectively contracting health care services from private providers.
According to a speech delivered by Health Minister Joe Phaahla during the signing ceremony on 15 May 2024, government’s intention ‘has always been to have a rational, structured and phased approach to implementation’. Possibly with that in mind, the Act’s sub-section 57(3) delegates a raft of phase-related responsibilities to various interim committees and structures to be established by the Minister. They include one on training and development.
In his speech, the Minister also noted that ‘without the accompanying regulations, directives, and operational procedures, the transformative impact of the Act cannot be realised’. With that in mind, work is apparently already under way on regulations for ‘shaping the governance of the … Fund and its enabling structures’. With the aim of ‘encouraging transparency and inclusivity’, these regulations will be released in draft form for public comment – although the Minister did not say when.
Published by SA Legal Academy Policy Watch
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