President Cyril Ramaphosa has again made it clear that government is not backing away from National Health Insurance, even as the law faces serious court challenges. In response to parliamentary questions this week, Ramaphosa said the NHI remains a firm government commitment and that preparation work will continue while the legal process plays out.

That stance comes after the Presidency announced on 24 February 2026 that no sections of the NHI Act would be proclaimed until the Constitutional Court has ruled on challenges linked to the legislative process. Those matters are due to be heard from 5 to 7 May 2026.

What Government Says is Already Under Way

Ramaphosa said the Department of Health has already been working on the systems needed to support the scheme. That includes processes to register people who will use NHI, rules for accrediting health facilities and providers, and contracting arrangements for healthcare services.

He also said digital health systems are being rolled out to help track patients across doctors, healthcare workers and facilities in both the public and private sectors. These systems include a Health Patient Registration System linked to the Department of Home Affairs population register, as well as an Electronic Medical Record system. According to Ramaphosa, these tools are expected to be introduced across more than 3,500 public healthcare facilities over the next 15 months.

Court Cases Pause the Law, Not the Project

Ramaphosa said the delay in proclaiming sections of the Act is meant to allow legal disputes to be handled in an orderly way without prejudicing any party. But he insisted the court process will not derail the broader timetable for implementation work already under way.

He added that government is also pushing practical steps to improve healthcare access and quality, including upgrading old hospitals, building new clinics and health centres, and focusing on the employment of doctors, health professionals and community health workers.

Funding Remains the Big Unanswered Question

While Ramaphosa says NHI implementation will continue, the money question still hangs over the project. He said the rollout will depend on available financial resources. The NHI Act points to budget allocations, possible new tax measures and the removal of medical aid tax credits as potential funding sources, but those changes would still need action from National Treasury through separate legislation.

For now, the message from the Presidency is clear: the legal fight may slow the law, but government says the NHI machine is still moving.