National Health Insurance Bill [B11-2019]

The Portfolio Committee on Health invites you to submit written submissions on the National Health Insurance Bill [B11-2019]

The objective of the Bill is to achieve universal access to quality health care services in the Republic in accordance with section 27 of the Constitution; to establish a National Health Insurance Fund and to set out its powers, functions and governance structures; to provide a framework for the strategic purchasing of health care services by the Fund on behalf of users; to create mechanisms for the equitable, effective and efficient utilisation of the resources of the Fund to meet the health needs of the population; to preclude or limit undesirable, unethical and unlawful practices in relation to the Fund and its users; and to provide for matters connected herewith.

Comments must be submitted to Ms Vuyokazi Majalamba at [email protected]  by no later than Friday, 29 November 2019

Enquiries can be directed to Ms Vuyokazi Majalamba at [email protected] and 021 403 3770 or 083 709 8522

Public hearings on the bill started in Mpumalanga from 25-28 October. Thereafter, they moved to the Northern Cape from 1-4 November. [public hearings]. Further hearings will be held in Limpopo (15-18 November), KwaZulu-Natal (22-25 November) and the Eastern Cape (29 November to 02 December). See full details here

You can track the processing of the Bill here

Read our interview with the Health Committee Chairperson here

Read our blog on the: NHI timeline

NHI Library (source: Collaboration for Health Systems Analysis and Innovation (CHESAI))

The Bill has been tagged/classified as a section 76 bill (ordinary bill affecting provinces). The process of classifying a Bill into one of four categories is called "tagging" and will determine the procedures the Bill must follow to become law. Bills are tagged by the Joint Tagging Mechanism (JTM), a Committee consisting of the Speaker and the Deputy Speaker of the National Assembly and the Chairperson and Permanent Deputy Chairperson of the National Council of Provinces. They are advised by the Parliamentary Law Adviser. The JTM decides on the classification of the Bill by consensus.

This Bill in substantial measure falls within the ambit of ‘‘health services’’ which is an area listed in Part A of Schedule 4, which makes provision for functional areas of concurrent national and provincial legislative competence.

In the Tongoane judgment the CC held that the tagging test focuses on all the provisions of the Bill in order to determine the extent to which they substantially affect the functional areas listed in Schedule 4 and not on whether any of its provisions are incidental to its substance

The CC further held that the test for tagging must be informed by its purpose. Tagging is not concerned with determining the sphere of government that has the competence to legislate on a matter. Nor is the purpose concerned with preventing interference in the legislative competence of another sphere of government. The process is concerned with the question of how the Bill should be considered by the provinces and in the National Council of Provinces, and how a Bill must be considered by the provincial legislatures depends on whether it affects the provinces. The more it affects the interest, concerns and capacities of the provinces, the more say the provinces should have on its content