Pain for people on medical aid: Private healthcare faces shake-up as NHI showdown looms
Middle- and lower-income earners could face rising costs for private healthcare cover.
Image: Pixabay
Medical schemes in South Africa continue to operate in a state of uncertainty as legal challenges against the National Health Insurance (NHI) Act make their way through the Constitutional Court.
Until the court rules, the future scope of private medical cover, affordability and the structure of contributions remains unclear.
Government has also begun phasing out medical aid tax credits, said Alexforbes.
These currently provide around R34 billion a year in relief to taxpayers belonging to private schemes, the financial services organisation said.
Alexforbes explained that these funds are expected to be redirected to the NHI.
This means that middle- and lower-income earners could face rising costs for private cover, with potential knock-on effects for household budgets and employer-sponsored benefits.
Under the current NHI framework, medical schemes will be limited to offering only complementary cover – services not included in the NHI.
What counts as “complementary” will influence both scheme contributions and the tax rates required to fund the system, which will directly affect members’ costs, said Alexforbes.
President Cyril Ramaphosa signed the NHI Act into law on May 15 last year, creating a single, state-funded National Health Insurance Fund to purchase and pay for healthcare services for all South Africans.
The Act has faced multiple legal challenges.
Key concerns include limited patient choice, unclear service coverage, centralised complaints handling, and extensive state control over private healthcare.
The Western Cape government, trade union Solidarity, Sakeliga and other groups have challenged the law, arguing that Parliament failed to ensure proper public participation and that key provisions, such as the “certificate of need”, are unconstitutional.
Several cases are set to be heard by the Constitutional Court, which will ultimately decide the fate of the Act. Solidarity’s hearing started September 9.
On the evolving landscape, Fazlin Swanepoel, Head of Health at Alexforbes, said: “As NHI developments unfold, collaboration between public and private sectors remains essential in promoting equitable access for all.”
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