President Cyril Ramaphosa and Health Minister Dr Aaron Motsoaledi have agreed not to proclaim or implement any sections of the National Health Insurance (NHI) Act until the Constitutional Court delivers judgment on separate challenges to Parliament’s public-participation process.
The agreement was recorded in a High Court order on 24 February after the parties agreed to halt related litigation. It follows a letter dated 20 February from the Office of the State Attorney, acting for the President, confirmed that Ramaphosa has formally undertaken not to promulgate any sections of the Act until the Constitutional Court delivers judgment.
Read: Ramaphosa pauses NHI promulgation pending ConCourt ruling
The agreement – made an order of the High Court in Pretoria by Judge Brenda Neukircher – temporarily stays multiple court actions that challenge how the NHI Bill was adopted and whether the President’s decision to sign it into law was rational. The stay means no sections of the Act will be brought into force while the Constitutional Court considers the procedural challenges.
A range of private sector and civil society bodies had launched litigation. Those named in the High Court filings include Solidarity, the Hospital Association of South Africa, the South African Medical Association, the Health Funders Association, the SA Private Practitioners Forum, the Board of Healthcare Funders, and business lobby group Sakeliga.
The High Court order also recorded that the parties would not mount further challenges to the Act without leave of the Court except in exceptional circumstances.
In a statement, the Presidency described the undertaking as limited to delaying proclamation and said it did not change the government’s commitment to universal health coverage. At the same time, the Department of Health will continue preparatory work to strengthen public health services ahead of any future commencement of sections of the law.
In a press statement, Solidarity welcomed the provisional suspension and said it has sent a letter of demand to the Presidency, the Department of Health, National Treasury, and relevant ministers warning against any contravention of the order.
Solidarity repeated its view that the NHI is unaffordable and said no further budgetary concessions should be made for the scheme, signalling it would bring further legal action if the government did not comply.
The Constitutional Court is scheduled to hear the procedural challenges from 5 to 7 May. If the apex court dismisses those challenges, the stay in the High Court order provides a mechanism for the parties to return to the lower court to determine how the remaining litigation should proceed.
The NHI was signed into law by the president on 15 May 2024; that timing and the parliamentary process have been central to the procedural disputes now before the courts.
For now, the pause removes the immediate prospect of sections of the NHI being brought into force. The legal proceedings are likely to determine both the timing and the legal pathway by which any future implementation would proceed, and they leave policymakers and stakeholders to continue technical and administrative preparations while the courts decide the procedural questions.
