SA’s NHI project is heading into a critical legal test as the Constitutional Court (ConC) reviews whether Parliament followed proper public participation when passing the law. President Cyril Ramaphosa is expected to argue before the Court that the NHI is a necessary step to address deep inequality in access to healthcare inherited from apartheid. – Business Times (26 April 2026)
Meanwhile, the Board of Healthcare Funders (BHF), representing medical schemes covering about 4.5m people, claims the consultation process was inadequate and lacked critical cost details. Estimates suggest the NHI could cost between R450bn and over R1trl annually.
Other bodies with pending challenges that are currently on hold pending this outcome include: the Western Cape, Solidarity, Sakeliga, AfriForum, Hospital Association of SA, SA Medical Association and SA Private Practitioners Forum.
If the Court finds that the legislative process was flawed, it could order Parliament to redo parts of it. That could delay the NHI’s legislative pathway and shift political pressure into the 2029 election period.
A favourable ruling could accelerate policy certainty, even as funding and operational questions persist. Ultimately, the outcome will shape the trajectory of universal health coverage and healthcare reform in SA.
https://www.businessday.co.za/business-times/2026-04-25-high-stakes-nhi-battle-heads-to-constitutional-court/
[BACK TO NEWS]