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Major Breakthrough for Medical Aid Members: Government Considers Key Changes to NHI Act

South African medical aid members may soon find relief as political leaders reportedly reconsider key aspects of the National Health Insurance (NHI) Act. This follows concerns over the future of private medical schemes under the NHI and an informal agreement between the African National Congress (ANC) and the Democratic Alliance (DA).
According to Planning, Monitoring and Evaluation Minister Maropene Ramokgopa, discussions are underway to ensure that the NHI does not dismantle private medical aids, a move that could signal a major shift in government policy.
Also Read : Warning for South Africans: Keep Your Medical Aid as NHI Faces Delays and Challenges
A Turning Point for the NHI?
A key point of contention in the NHI Act is Section 33, which prevents medical aid schemes from covering services already provided by the NHI. This clause has been heavily criticized by:
- Healthcare professionals
- Business organizations
- Medical aid providers
- Opposition parties, including the DA
However, according to reports, government ministers, including Health Minister Aaron Motsoaledi and DA leader John Steenhuisen, are considering amendments that would allow medical aids to continue operating alongside the NHI.
Additionally, there are discussions about creating a ministerial advisory council to oversee the NHI’s integration with South Africa’s current healthcare system.
Also Read: South Africa Battles for Universal Healthcare: Health Minister Defends NHI at WEF
Why Section 33 Matters
Motsoaledi has been one of the strongest advocates for keeping Section 33 intact, arguing that it is essential for the NHI’s success.
He previously stated that removing Section 33 would be like “building a house without a foundation” and has taken a hard stance against those opposing the Act, including legal challengers.
However, even he has acknowledged the need for policy discussions and possible amendments, noting:
“There is no law on earth that is cast in stone, that never changes.”
Despite this, he remains firm on healthcare financing reform, dismissing critics who oppose any form of change.
Political Pressure and the GNU’s Influence
The ANC’s loss of its parliamentary majority in the 2024 national elections forced the party to form a Government of National Unity (GNU) with the DA, IFP, and other parties—many of whom do not support the NHI in its current form.
Motsoaledi has stressed that this is not an alliance, but rather a practical political arrangement. Despite ideological differences, negotiations are now crucial for the NHI’s future.
Legal Challenges and Uncertainty
The NHI Act is already facing three major legal challenges, with more expected to follow. One of the biggest concerns is the lack of clarity on when the NHI will be considered “fully implemented.”
- Medical aid members worry that private schemes will be phased out too soon.
- Businesses and healthcare providers argue that the government has not provided a clear roadmap.
- Critics fear government overreach due to vague wording in the Act.
This uncertainty has fueled widespread anxiety among South Africans who rely on medical aid for private healthcare access.
What’s Next? A Possible Hybrid Healthcare Model
The reported agreement between the ANC and the DA could pave the way for a more flexible healthcare model that integrates both public and private systems.
One alternative proposal suggests:
- Mandatory medical aid for employed individuals, reducing reliance on public healthcare.
- A hybrid system where medical aids operate alongside NHI, allowing people to choose their preferred healthcare model.
- Private sector collaboration, easing the financial burden on the government.
While no official changes have been confirmed, these discussions mark a significant development in South Africa’s healthcare landscape. If amendments to Section 33 move forward, millions of medical aid members could be reassured about their healthcare options.
With ongoing legal battles and political negotiations, the future of the NHI remains uncertain, but this latest development signals that compromise may be on the horizon.
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