News FlashesAugust 15, 2019

CRS News Flash 14 August 2019 – SOUTH AFRICA – National Health Insurance Bill 2019


It is important that employers note the following:

National Health Insurance Bill published

The Department of Health published and introduced the National Health Insurance (NHI) Bill 2019 to the National Assembly on Thursday, 8 August.

The Bill aims to achieve the following:

  • Universal access to quality health care services in the Republic in accordance with section 27 of the Constitution
  • To establish a National Health Insurance Fund and to set out its powers, functions and governance structures;
  • To provide a framework for the strategic purchasing of health care services by the Fund on behalf of users;
  • To create mechanisms for the equitable, effective and efficient utilisation of the resources of the Fund to meet the health needs of the population;
  • To preclude or limit undesirable, unethical and unlawful practices in relation to the Fund and its users; and
  • To provide for matters connected.

Also, the government says the aim of the NHI is to help medical scheme members with their high out-of-pocket costs. At the same time, it also acknowledges that state medical staff and hospitals can’t cope with treating the majority of South Africans who don’t have medical aid.

However, there remain huge concerns about whether the government can afford and manage its NHI plans.

A summary of what can be expected:

  • Every South African citizen will become a member of the NHI Fund.
  • Citizens who earn an income will contribute towards the NHI Fund.
  • The contribution percentage that could be levied on an employee and its employer has not yet been determined.
  • Government will levy an extra tax on taxpayers’ personal income and use the money it will save by not giving taxpayers tax credits for being a member of a medical scheme.
  • Government will use South African citizens’ tax money, as well as some of its healthcare budget, to buy services from public and private doctors, specialists and hospitals that are accredited with the state.
  • The fund will cover a range of medical services, treatments and procedures for free, except if it is not a medical necessity.
  • On an annual basis, the government will determine what prices will be paid for by specific services.
  • Citizens might be expected to register with a general practitioner (GP) who is contracted with the state. Each contracted GP might have a set number of patients who they will service for the NHI Fund.
  • There will be strict rules about seeing specialists. Citizens won’t be able to go directly to a specialist but will have to obtain a referral first.
  • The state will buy medicines for everyone.
  • Medical schemes may disappear.
  • Foreigners won’t be covered. Foreigners visiting South Africa must have travel insurance to receive health care services through the NHI Fund.
  • The fund will be managed by a CEO, who will be appointed by the Minister of Health.

Once the Bill is assented by the President, it will become law on a date fixed by the President by proclamation in the Government Gazette.

Contact our legislation team at if you require any additional information.
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