NATIONAL HEALTH INSURANCE (NHI) BILL UPDATE

The National Health Insurance Bill is finally nearing the end of the first leg of its passage through Parliament. According to a media statement on committee meeting highlights for the week ending Friday 12 May 2023, the National Assembly’s Health Committee is scheduled to meet:

  • on 10 May 2023 to:
    • consider legal opinions on the Bill from the Office of the State Law Adviser and a parliamentary legal adviser, and
    • deliberate on the Bill clause by clause, and
  • again on 12 May 2023 to deliberate on an ‘A-List’ of proposed amendments to the Bill.

Tabled in August 2019, the Bill seeks to establish a national health insurance fund as the next step in moving towards ‘universal coverage’, allowing government to serve as ‘a strategic and active purchaser of personal health care services’. According to a memorandum on the Bill’s objects, this will enable all South Africans to access ‘high quality health care’.

The intention is that, over time, additional services will be added to the list of those initially covered by NHI and financed from the proposed new fund. This is expected to reduce the extent to which patients are required to make direct, out-of-pocket payments for health services.

The Bill has been the focus of a long public participation process that began in May 2021 and included public hearings in the provinces – eventually ending in February 2022.

In March 2023, Deputy Chief State Law Adviser, Ayesha Johaar, and parliamentary legal adviser, Sueanne Isaac, briefed the committee on contentious clauses in the Bill with the potential to give rise to a Constitutional Court challenge. According to Parliamentary Monitoring Group reports on these meetings, disparities in the views expressed in reports submitted by the two legal advisers prompted the committee to call for clarity on certain matters. This delayed the process by a further six weeks.

Published by SA Legal Academy Policy Watch

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