The Health Funders Association (HFA) HFA, representing most of SA’s medical schemes has petitioned the Court to declare the National Health Insurance (NHI) Act landmark legislation ‘irrational and unconstitutional’, reported Business Day (5 June 2025)
The HFA has raised concerns regarding the financial implications of the NHI Act, particularly Section 33. If fully implemented, Section 33 will prohibit medical schemes from “offering cover for benefits provided by the NHI, a move the HFA argues would effectively destroy the private medical scheme industry”.
The HFA's petition states that SA ‘lacks both the funds and the healthcare professionals’ to implement the NHI Act.
According to a report from economic consultancy, Genesis Analytics, the NHI would cost more than R900bn a year –R410bn more than SA’s current total healthcare expenditure.
The report indicates that for the NHI to match the level of care currently provided by medical schemes, the country would need to double its number of general practitioners and triple its specialist count.
“The HFA, in line with alternatives previously suggested by other stakeholders, has proposed a hybrid model for healthcare combining the NHI with a supplementary role for medical schemes. “Under this proposal, all taxpayers would contribute to the NHI Fund, but individuals would retain the choice to belong to a medical scheme for additional cover. This approach aligns with an earlier NHI policy position that was abandoned in the final White Paper on NHI in 2017.”
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