Human rights lawyer, Femi Falana (SAN), has said that every Nigerian is now legally entitled to compulsory health insurance under the National Health Insurance Authority (NHIA) Act of 2022.

In a statement made available to The PUNCH on Friday, Falana explained that the NHIA Act repealed and replaced the National Health Insurance Scheme Act of 2004, which he said had failed to achieve “significant population coverage or integration” of Nigeria’s fragmented health insurance system.

According to him, the 2022 law “represents a major policy and legal shift toward making universal health coverage a legal and operational reality for all Nigerians.”

He noted that the Act mandates the enforcement of a Basic Minimum Package of Care for all citizens, while also establishing the Vulnerable Group Fund to subsidise care for the poor, elderly, children under five, and persons living with physical or mental disabilities.

Falana added that state governments are required to operate their own health insurance schemes or engage third-party administrators until such schemes are established.

“In accordance with the NHIA, on September 3, 2025, President Bola Tinubu directed all Ministries, Departments, and Agencies (MDAs) to enrol their employees in the National Health Insurance Authority scheme,” he said.

“To ensure compliance across all MDAs, the directive mandates all entities participating in public procurement to present a valid NHIA-issued Health Insurance Certificate,” Falana added.

He explained that the directive also empowers the Secretary to the Government of the Federation to enforce enrolment and monitor compliance, potentially expanding health coverage significantly across public institutions.

Falana further said the NHIA Act mandates the governments of the 36 states and the Federal Capital Territory to provide a basic minimum package of care to all residents of Nigeria, in line with the Basic Health Care Provision Fund under the National Health Act 2014.

He noted that “state health schemes will manage the fund and monitor its implementation,” while states without established schemes may use third-party administrators pending the creation of their own.

“The primary aim of the NHIA Act is to ensure that every Nigerian and legal resident has access to affordable, quality, and comprehensive health care services through mandatory health insurance,” he said.

Falana pointed out that the NHIA had now set up “a regulatory and institutional framework for the promotion, administration, supervision, and regulation of all health insurance schemes in Nigeria — whether public or private.”

Citing the Health Care Providers Association of Nigeria, Falana lamented that “over 90 per cent of Nigerians are still not covered by any form of health insurance,” warning that the country remains far from achieving universal health coverage.

He attributed the situation largely to poverty, noting that “millions of citizens have become dimensionally poor.”

Quoting Section 25 of the NHIA Act, Falana said health insurance for vulnerable people “shall be fully funded by the government,” while Section 31 requires employees to contribute on a contributory basis.

He explained that the law defines the “vulnerable group” to include “children under five, pregnant women, the aged, the physically and mentally challenged, and the indigent as may be defined from time to time.”

“Since the majority of citizens have become indigent and vulnerable, the federal, state, and local governments should provide adequate funding for the health insurance of all citizens,” Falana stated.

He said this demand aligns with Section 17(3)(d) of the Nigerian Constitution, which imposes a duty on the government to ensure “adequate medical and health facilities for all persons,” as well as Article 16 of the African Charter on Human and Peoples’ Rights, which guarantees every individual “the highest attainable standard of physical and mental health.”

PUNCH Online on September 25, 2025, reports that President Bola Tinubu’s directive to enforce the National Health Insurance Authority Act (2022) across all ministries, departments, and agencies has been hailed as a significant step forward for Nigeria’s health system.

The order mandates MDAs to enrol their employees in the NHIA scheme and makes possession of a valid Health Insurance Certificate a prerequisite for public procurement, licensing, and other official approvals. It also provides for the creation of a digital verification platform to enhance transparency and prevent forgery.

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