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Communication prepared by the Board of Healthcare Funders (BHF)

November 2024 

Following the publication of the draft regulations under the National Health Insurance (NHI) Act, we understand that you may have questions and concerns. We want to reassure you that this development represents an early preparatory phase in the anticipated lengthy and intricate process leading to the full implementation of the NHI Act.  It is unlikely to have an immediate impact on medical schemes. 

The government is legally permitted to prepare for the commencement of a law by drafting regulations for public comment and engaging in other activities such as planning for its implementation. These preparations include system development, human resource planning, appointing officials, and setting up structures in advance.When the President or relevant authority formally announces the commencement date of an Act or specific sections of it via government gazette, they must take these steps to prevent operational challenges.

The Minister of Health must publish regulations for public comment for at least three months before finalising them, as mandated by Section 55(2) of the NHI Act. These regulations will set out in more detail the processes and procedures for implementing various sections of the Act. All comments received must then be considered by government and incorporated into the final regulations published by the Minister. 

So, the publication of regulations does not mean that the NHI Act is immediately operational – it must be proclaimed. The President may issue proclamations over time, activating different sections of the Act as readiness allows. To date, none of the sections of the NHI Act have been proclaimed. We expect that the NHI Act is likely to be implemented in stages to ensure that the necessary structures and systems are fully established before it comes into effect. 

Our Commitment to Universal Health Coverage

As the medical scheme industry, we remain fully committed to advancing South Africa’s journey toward universal health coverage. We remain committed to collaborating with the government to accomplish this objective. However, we believe that the current form of the Act weakens rather than strengthens the health system by diminishing the crucial role of the medical scheme sector, which offers quality healthcare to at least 9 million South Africans.

Following President Ramaphosa's signing of the Bill into law in May, our industry association, the Board of Healthcare Funders (BHF), has filed a legal action with the Gauteng High Court. This legal challenge aims to ensure that the act prioritizes the interests of medical scheme beneficiaries as well as all South Africans.

What This Means for You

For now, your current medical scheme benefits remain unchanged, and there is no immediate cause for concern. We will continue to:

• Monitor Developments: Closely track any updates or changes to the NHI Act or its regulations.
• Advocate for Beneficiaries: Ensure that your voice and interests are represented during this process.
• Keep You Informed: Provide timely updates on any developments that may affect you.
  If you have any questions or require further information, please visit www.thehealthcitizen.co.za