By Lesedi Sibiya-Diplomatic Insider 

As far as President Cyril Ramaphosa is concerned the National Health Insurance (NHI) is not subject to negotiation, as the government stands firm in regards to its implementation, despite the mounting opposition towards it. 

Ramaphosa and Health Minister Aaron Motsoaledi had used the opening of King Nyabela Hospital in Mpumalanga in order to defend the controversial policy. They have both insisted that NHI is critical to closing the gap between public and private healthcare. 

The insistence on NHI and its defense had heavily clouded the opening of the new hospital in Mpumalanga as both the minister and the president had used the platform to respond to critics who are opposed to NHI.

“It (NHI) equalises poor people with rich people and that’s why those who believe they are rich will oppose it. They don’t want the madam to lay in the same ward as their domestic worker” said Motsoaledi. 

Ramaphosa also held the same sentiments as the minister. The NHI Act remains the subject of legal challenges from several organisations, however the government has said that it remains committed to rolling out universal healthcare and coverage.

“At its heart, the NHI is about fulfilling the constitutional right of access to healthcare, without this being dependent on where one lives or one’s ability to pay” said Ramaphosa.

In February 2026, Ramaphosa put a moratorium on the rollout of NHI, pending the outcome of a May 2026 Constitutional Court challenge against the drafting of the NHI act. As part of the hold the president agreed to stay the promulgation of any provisions of the NHI Act until the court had ruled on the matter.