Health Insurance Act’s legal challenges unpacked

The controversial National Health Insurance Act, which was signed into law by President Cyril Ramaphosa two weeks before the elections, and now faces several legal challenges, was the subject of much discussion at the Healthcare Funders’ Association symposium on Wednesday. The Daily Maverick reports that there are already six legal challenges in the works from Solidarity, the Health Funders’ Association, the SA Medical Association, the Board of Healthcare Funders (BHF), the SA Health Professionals Collaboration and the DA. However, Elsabe Klinck, MD of Elsabe Klinck and Associates, said she anticipates that as more cases are filed, they will be consolidated. ‘That might delay things in the beginning, because you’ll have more sets of advocates that will need to coordinate their diaries and so on, but then we can have a single ruling,’ Klinck said.

Dr Paula Armstrong, a director at FTI Consulting, noted that an NHI white paper published in 2017 pegged the total cost of the NHI in 2025 at R256bn – the same figure that was quoted in the 2015 white paper on the NHI. DM notes that she said one of the bugbears at the symposium was that ‘costing for National Health Insurance is out of date and anchored in highly unrealistic assumptions’. ‘So, from an economic perspective, there hasn’t been a lot of, or any, development in the thinking around what the cost will be. Of course, it depends on what will be included in the benefits package, and we don’t know this yet from a policy perspective or an economic policy perspective,’ she said. Klinck said that in the two cases already filed by the Board of Healthcare Funders and Solidarity, it was important to note who was being sued in each case. ‘The BHF is suing the President and the Minister of Health, while Solidarity is suing the Minister of Health, the President, the DG, the Minister of Finance and National Treasury. This means there are two cases with two different approaches,’ she said. The BHF has asked for the President’s signing of the Act to be set aside so that the NHI Act is declared of no force and effect. The BHF has also asked for the record of decision-making, that is, what led to the President signing NHI, and what legal opinions from the State Attorney were considered.

Full Daily Maverick report