Health Funders Association hoping for NHI rethink under new government

The Health Funders Association (HFA), a key  industry group for medical schemes, says it is optimistic the new government of national unity will offer scope to reconsider the controversial National Health Insurance (NHI) Act.

The HFA’s members, the biggest of which is Discovery Health Medical Scheme, provide cover to about half of SA’s 9-million medical scheme beneficiaries,

The NHI act proposes sweeping health reforms aimed at achieving the ANC’s vision for universal health coverage. President Cyril Ramaphosa signed it into law two weeks before the general election on May 29. However, not one of the act’s sections has been proclaimed so none of its provisions has been brought into effect at this stage.

“Our optimism stems from the fact that there are lots of invitations to almost re-engage on the NHI,” said HFA chair Craig Comrie, declining to elaborate further. “Maybe we will see a softening in terms of ... implementation or a rethink on more practical and realistic ways of implementing NHI. There is optimism (about) the new government and a change in the balance of power,” he said in an interview with Business Day shortly after delivering the opening address at an HFA seminar on NHI.

The ANC was forced to form a government of national unity after failing to win enough votes to secure a majority, bringing the DA, PA and IFP into a new power sharing arrangement. The DA and IFP rejected the bill in the National Assembly. The PA was not previously represented in parliament but said in its election manifesto the state must first prove it can use allocated resources before asking for more.

It is not yet clear who Ramaphosa will appoint as ministers of health or finance, the two cabinet positions that will wield greatest influence over the future trajectory of NHI.

The HFA was still intent on pressing ahead with its constitutional challenge to the NHI act, but was optimistic there would be opportunities to “engage on a more pragmatic approach to health reform” with the new government, said Comrie.

The HFA’s NHI steering committee chair Charlotte Mbewu said it might be possible for the new administration’s parliament to repeal the NHI act on constitutional grounds. Section 80 of the constitution says parliament may apply to the Constitutional Court to declare part or all of an act to be unconstitutional, provided the application is supported by at least  a  third of the members of the National Assembly and that it is done within 30 days of the president signing the act.

While more than 30 days had passed since Ramaphosa signed the NHI act on May 15, the Constitutional Court might extend the 30-day period because there had not been a National Assembly during this period. The last parliament’s term expired on May 21.

Two legal challenges to the act are already in play, with several more expected soon  follow. Trade union Solidarity has taken aim at the legislation on constitutional grounds, while the Board of Healthcare Funders (BHF), an industry association for medical schemes and administrators, honed in on the president’s powers and responsibilities when he considers legislation.

kahnt@businesslive.co.za