National Health Insurance Authority Act 2022 (NHIA Act 2022)

What Is This Policy?

The National Health Insurance Authority Act 2022 replaces the defunct National Health Insurance Scheme (NHIS) Act 1999, establishing a reformed, mandatory health insurance framework designed to move Nigeria toward Universal Health Coverage (UHC) by ensuring all Nigerians have financial protection against the cost of healthcare services.

Who Does It Target?

All Nigerians and legal residents, with mandatory enrolment for formal sector employees and their dependants Informal sector workers, self-employed persons, and rural populations previously excluded from health insurance Vulnerable groups: children under five, pregnant women, the elderly, and persons with disabilities who may access subsidised coverage Public and private sector employers required to enrol employees and contribute to premiums

What Does It Aim to Achieve?

Achieve Universal Health Coverage for at least 80% of Nigerians by 2030 under the SDG 3.8 target Eliminate catastrophic out-of-pocket health expenditure, which currently accounts for over 70% of total health spending in Nigeria Pool health risks across the population so that the healthy subsidise the sick and the wealthy subsidise the poor Strengthen state health insurance schemes, which the NHIA is required to coordinate, certify, and integrate into the national framework

Key Features

Mandatory Coverage: The Act makes health insurance mandatory for all Nigerians, unlike the voluntary NHIS which covered only about 3% of the population in 22 years Basic Minimum Package: A defined Basic Minimum Package of Health Services (BMPHS) covers primary care, selected secondary care, maternal and child health services, and emergency care Equity Fund: A vulnerability pool within the scheme provides subsidised coverage for the extremely poor, children under five, and pregnant women from government revenue State-National Integration: State Health Insurance Agencies are formally integrated into the national framework; the NHIA certifies state schemes to ensure minimum benefit standards Multiple Payers: Health Maintenance Organisations (HMOs) are retained as approved payers; the NHIA acts as regulator, not sole payer Portability: Coverage is portable nationwide; enrolees can access healthcare in any state, not just where they enrolled

Current Status

In force, as it is described as an Act from 2022 that replaces the previous National Health Insurance Scheme Act and establishes a new framework.

Legal Framework

National Health Insurance Scheme Act 1999 (being repealed); Constitution of the Federal Republic of Nigeria 1999 (Chapter II, Section 17(3)(d) on health); National Health Act 2014; Finance Act