National Health Insurance (NHI) Bill adopted – what now?

In short

  • The impact of the potential implementation of NHI on the private healthcare sector, and ultimately the Society and its members, remain extremely unclear;
  • In view of the above, the Society has therefore adopted a ‘wait and see’ approach rather than speculating about such and alarming members unnecessarily; and
  • Having said that, the Trustees and Society Management are committed to doing everything in their power to protect the rights and benefits of our members.


The recent adoption of the NHI Bill by the National Assembly (Parliament) has understandably raised some questions from members with regard to:

  • the Society’s view of the Bill;
  • the impact on members and the Society; and
  • the Society’s action plan regarding this matter going forward.

As indicated at the recent Annual General Meeting (AGM) of members held on 13 July 2023, this Newsflash aims to provide members with an update regarding:

  • the process currently underway to finalise the NHI Bill, and how it is expected to progress;
  • the industry and Society’s view regarding NHI Bill (as opposed to and the concept of universal healthcare); and
  • the implication for the medical scheme industry, and in particular the Society and its members, as far as this can be foreseen from the information currently available.

The process of finalising the NHI Bill – still a long road ahead

As mentioned, the NHI Bill was adopted by the National Assembly on 13 June 2023. Despite its adoption, it is foreseen that the actual implementation of NHI will still take a few months if not a number of years as the following still needs to take place before the NHI Bill it can be enacted:

  • The NHI Bill must first be considered by the National Council of Provinces (NCOP);
  • Any proposed amendments by the NCOP, will need to be referred back to the National Assembly for consideration; and
  • If the Bill passes, the President still needs to approve such.

The industry and the Society’s views regarding the NHI Bill

Although the Society recognises and supports the importance of universal healthcare i.e. the concept that all SA citizens have access to a range of healthcare services that are not based on their ability to pay for such services, the current NHI Bill, unfortunately, does not make it clear what role medical schemes will ultimately play once NHI is implemented, as the definition of complimentary and top-up cover (which is the only cover medical schemes would be allowed to provide) is not clearly defined in the Bill. Without this clarity, it is virtually impossible for medical schemes at this stage to propose and/or anticipate changes that may be required to their benefit design (including the associated impact thereof on the cost to members) to comply with this particular provision of the Bill.

Furthermore, the NHI Bill and proposed implementation plans in its current form simply do not provide the medical scheme industry, nor its members, with enough details of how the healthcare sector would function, should NHI be implemented.

Implications for the industry, the Society and our members

As much as the Society would like to address members’ concerns, the details around the potential implementation of NHI are simply so unclear that any view of the Society at this stage would in all likelihood be speculative and only alarm members unnecessarily.

Regardless, based on the current available information the Society does not foresee any major changes to the private healthcare sector, and by implication to the Society and the benefits its current offerings in the foreseeable future.

The Society, as a member of the Health Funders Association (HFA), has participated in the engagements leading up to the drafting of the NHI Bill and will continue to engage with the HFA (including other industry role players and stakeholders) to ensure that our members are represented at hearings and that their rights are protected.

We will continue to keep you informed about developments regarding the NHI Bill and as more concrete clarity about the potential implementation of NHI becomes available.

Further reading

For more information about NHI and the healthcare industry’s concerns, please read this article prepared by the HFA.

Stanley Mathonzi