States are under pressure to bridge a 198.6 million deficit in social health insurance enrolment as the federal government releases the National Health Insurance Authority (NHIA) Act 2022 operational guidelines.
States governments have been saddled with the task of ensuring that all Nigerians across formal and informal sectors get mandatory coverage under the National Health Insurance Scheme.
Just over 17.8 million people are currently insured, according to the NHIA.
Muhammad Ali Pate, the coordinating minister of health and social welfare said on Wednesday that states will now play a lead role in driving people into the insurance net in line with the adjustments introduced by the Act.
In the coming days, only states are expected to set up health insurance authorities and begin to provide a basic minimum package of health services to enrolees.
They are to ensure that their employees are enrolled, with their premiums paid and the counterpart funding expected from states covered.
“What we need is for states to equally prioritise health and strengthen their institutions so that the disparities seen in population coverage are minimised,” Pate said during a televised interview.
He added: “All must enrol for the aspiration of the Act to materialise. We are providing that direction and an institutional backup through the NHIA framework, which private sector players can join.
“I call on all Nigerians to support this direction so that we begin to take into account the health of our population as a priority and not leave anyone out in terms of access to basic healthcare access.”
Read also: How Nigeria’s mandatory insurance will impact your health plans
All states have begun the implementation of the basic healthcare provision, but Lagos has taken the lead in the adoption of the Act.
Babajide Sanwo-Olu, governor of Lagos State, issued an executive order in July for the domestication of the Act to commence through its Ilera Eko social insurance scheme.
The state’s target is to expand coverage among those in the informal sector, the vulnerable, and the small and medium enterprises.
“This will make it possible for the agency to engage with all key stakeholders and ensure that residents of Lagos State have access to quality and affordable healthcare services, thereby moving the state closer to the attainment of UHC [universal health coverage],” Sanwo-Olu said during the first health insurance summit convened by the state.
The Act stipulates that state employers as well as the organised private sector pay 10 percent and employees pay a five percent contribution, which sums up to 15 percent of the employee’s basic salary.
Public sector employers on the federal level are to pay 3.25 percent of the contribution while employees pay 1.75 percent, representing 5 percent of the employee’s consolidated salary.
The operational guide also demands that the counterpart funding for services insured under the Basic Health Care Provision Fund (BHCPF) be provided.
The BHCPF is a financial tool developed to fund the basic minimum package mostly at the primary healthcare level, covering the operation cost of primary health centres and ensuring access for all including the poor.
In addition to this, a vulnerable group fund (VGF) has been introduced by the Act to secure insurance coverage for those considered the most vulnerable members of the populace.
Pate said some funds have been secured for this category and additional resources are expected to be strategically placed to complement what the government has provided.
This could be achieved if external partners, private sector players, and philanthropists lend support, he said, noting that roughly 1.7 million vulnerable Nigerians are covered through the VGF at the moment.
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