NHI is on hold until ConCourt rules. What it means for your medical aid
The Health Department told Parliament that NHI-specific work won't happen until the Constitutional Court rules on how the law was passed. No part of the NHI Act is in force, so medical aid cover stays as it is for now.
National Health Insurance (NHI) won't move forward until the Constitutional Court hands down judgment on whether Parliament passed the law properly. The Department of Health told Parliament's Select Committee on Social Services this week that MPs will not see NHI-specific interventions until then (Parliament).
For medical aid members, that means nothing changes for now. No section of the NHI Act has been put into operation, so your scheme, your plan and your cover carry on as before.
Why is NHI on hold?
In February 2026, President Cyril Ramaphosa agreed, after consulting Health Minister Aaron Motsoaledi, not to proclaim any section of the NHI Act until the Constitutional Court rules on the challenges it heard from 5 to 7 May 2026 (The Presidency).
Those cases are about the public participation process Parliament followed before adopting the NHI Bill. Judgment has not yet been delivered.
The Presidency said the undertaking would not affect the timetable for implementing NHI, and that government remains committed to the scheme (The Presidency).
What did the Health Department tell Parliament?
The department briefed the committee on its 2025/26 annual report. Director-General Dr Thembisile Xulu said work on "key elements" of NHI continues, including advisory structures, accreditation systems and electronic health records (Parliament).
When MPs asked why there was limited evidence of NHI's impact, they were told NHI-specific interventions would only come after the court's judgment (Parliament).
The committee, chaired by Desery Fienies, also raised concerns about infrastructure at public health facilities, maternal and newborn deaths, staff shortages and unemployed doctors (Parliament).
Does my medical aid change because of NHI?
Not at this stage. Because the President has undertaken not to bring any part of the Act into force before judgment, none of its provisions apply yet (The Presidency). That includes the parts dealing with what medical schemes may cover once NHI is fully running.
Any change to your benefits for 2027 comes from your own scheme's annual increases and option changes, not from NHI.
What happens after the court rules?
BusinessTech reports that if the court finds Parliament's process was flawed, the law could go back for public participation, setting it back years. If the court finds the process was valid, other challenges waiting in the courts would come next, including cases about private medical aids and specialist services (BusinessTech).
Either way, there is no date yet for when NHI services will start.
Is government still spending money on NHI?
Yes. According to BusinessTech's reading of the budget documents, the February 2026 budget set aside more than R9 billion linked to NHI, made up of R1.43 billion in direct NHI grants over three years and more than R7.8 billion in indirect funding for things like clinic upgrades and digital health systems (BusinessTech).
FAQ
Is NHI in force in South Africa?
No. President Ramaphosa undertook in February 2026 not to proclaim any section of the NHI Act until the Constitutional Court rules on challenges to Parliament's public participation process.
Does NHI affect my medical aid in 2026?
Not yet. Because no section of the NHI Act has been brought into force, medical schemes carry on as before.
When will the Constitutional Court rule on NHI?
There is no date. The court heard the public participation challenges from 5 to 7 May 2026 and has not yet delivered judgment.
Is NHI work still happening?
The Health Department told Parliament that preparatory work continues, including advisory structures, accreditation systems and electronic health records, but NHI-specific interventions will wait for the court's judgment.