Comparative policy content analysis of national health insurance laws and their implications for universal health coverage in Nigeria

Abstract: - Background Nigeria’s National Health Insurance Authority Act was signed into law on May 19th 2022 as a more viable option for achieving universal health coverage, over the former Act 42 of 2004 that established the National Health Insurance Scheme. This review compares the new Act with the former one with the aim to highlight any improvements in the new Act regarding the three key success features of health financing mechanisms, (i) sustainable sources of funding; (ii) equity in contribution and access to care; and (iii) strategic health purchasing. Methods The study is a document review and a health policy analysis comparing the National Health Insurance Scheme Act of 2004 and the National Health Insurance Authority Act of 2022. The different sections of the Acts and their implication for achieving UHC in Nigeria were analyzed and presented in themes and subthemes. The themes and subthemes were adapted from national health financing policy and strategy, they represent the key success features of health financing mechanisms. Results The findings showed that the new health insurance law in Nigeria is more focused in an equitable manner for total population coverage. While section 16 of the National Health Insurance Act Cap 42 of 2004 did not make contributions by employers and employees compulsory, section 14 of the new National Health Insurance Authority Act makes health insurance contribution mandatory to all residents in Nigeria. The 2022 Act also created the Vulnerable Group Fund and identified funding sources for the coverage of the vulnerable population. Conclusion The National Health Insurance Authority Act contains several success features that could contribute to the achievement of UHC in Nigeria. Stakeholders need to key in to ensure the successful implementation of the Act.