SACP slams Ramaphosa for halting National Health Insurance implementation

The South African Communist Party (SACP) has sharply criticised President Cyril Ramaphosa for suspending the implementation of the National Health Insurance (NHI), describing the decision as “opportunistic, irrational, and a blatant attack on the struggle for universal healthcare.” The move comes after Ramaphosa formally committed to suspending the implementation of all provisions of the NHI Act until the Constitutional Court of South Africa delivers its judgment on the legal challenges before it. In a letter dated February 20, 2026, the Office of the State Attorney confirmed that no sections of the legislation will be implemented until judgment is delivered in the so-called “public participation challenges,” lodged by groups including Solidarity, the Board of Healthcare Funders, the South African Private Practitioners Forum and the Western Cape Provincial Government. Health Minister Aaron Motsoaledi had earlier assured that the government would not request implementation until the court resolves the disputes.

The Constitutional Court has scheduled hearings for May5–7, 2026 and issued directions for further submissions. Ramaphosa said the decision was intended to “ensure orderly legal process and avoid overlapping proceedings,” adding that implementation of legislation as transformative as the NHI also depends on departmental readiness. Two years after the Act was signed into law, the ambitious healthcare reform remains in limbo, stalled by sustained legal and political opposition, including from the Democratic Alliance, private medical schemes and other stakeholders who argue the law was adopted without adequate public participation and is fiscally unsustainable.

SACP national spokesperson Mbulelo Mandlana said the backlash was anticipated. Mandlana said that if reactionary political forces had their way, the idea of universal health coverage and dismantling the two-tier health system wouldn’t even be debated, and the National Health Insurance would never have been signed into law, no matter how delayed its rollout.