Lagos Works to Harmonize Health Scheme Law with NHIA Act, Aims to Enhance Health Insurance Landscape — ZAMBA

In a concerted effort to enhance the health insurance landscape within Lagos, the Lagos State Health Scheme Law is currently undergoing a comprehensive review. The objective behind this initiative is to ensure that the Lagos State Health Insurance Scheme seamlessly aligns with the mandates of the National Health Insurance Authority Act (NHIA).

To address ambiguities between the state’s Health Scheme and the provisions outlined in the NHIA Act, a draft law has been meticulously crafted to repeal the existing state legislation and realign it with the national framework.

Dr. Emmanuella Zamba, the Permanent Secretary of the Lagos State Health Management Agency (LASHMA), revealed this pivotal development during a gathering in Lagos. According to Zamba, while the national legislation mandates universal social plans, the state law currently falls short in this regard.

Speaking at the Joint Learning Agenda (JLA) stakeholder engagement event, which brought together participants from Lagos Civil Society Participation for Development (LACSOP), Joint Learning Agenda for Universal Health Coverage (JLA4UHC), media representatives, and other stakeholders, Dr. Zamba highlighted the overarching goal: to ensure that every individual in Lagos gains access to high-quality healthcare services without bearing an undue financial burden.

The imperative of reviewing the state law stems from the need to bridge gaps and facilitate the seamless execution of mandatory health insurance within the state.

Dr. Zamba noted, “While the NHIA Act is a significant piece of legislation, it is not without its limitations. Our exhaustive assessment of the document has pinpointed certain gaps, particularly concerning the federal government’s authority over state health insurance, which operates within the concurrent list and possesses its own legislative nuances.”

She emphasized, “We find ourselves grappling with questions of jurisdiction. Where does the federal government’s jurisdiction terminate, and where does the state’s jurisdiction commence? It is clear that we cannot oversee a state health insurance scheme without a well-regulated framework in place. These challenges must be met head-on. We are actively working towards revising the Lagos State Health Scheme Law to harmonize it more effectively with the national law, all while keeping our unique context in mind.”

In this vein, Dr. Zamba underscored the drafting of a law commission engagement proposal, awaiting the assignment of a legislative principal to lead the initiative.

“The groundwork has been laid for our engagement with the law commission; we are eagerly awaiting the designation of the legislative principal who will guide this crucial process,” she commented.

Elucidating further, Dr. Zamba clarified that operational guidelines are interpretative, not legally binding in nature.

“While operational guidelines offer insights into effective implementation strategies, states are not legally bound to adopt them wholesale. They serve as interpretative blueprints, not ironclad laws. It is vital to comprehend that these guidelines, while informative, should be tailored to individual states, as adopting a ‘one-size-fits-all’ approach would be counterproductive.”

Reflecting on the agency’s funding, Dr. Zamba revealed that the Agency received 100 percent of the Basic Health Care Provision Fund (BHCPF) in 2022 and a 50 percent allocation from the federal government in 2023.

Presenting the scorecard on demand generation for mandatory health insurance, Ms. Olayide Akanni, Coordinator of the JLA4UHC, highlighted the group’s ongoing assessment of compliance with the NHIA Act in both Lagos and Kano states. Akanni emphasized that the JLA4UHC, a civil society-led initiative, was established with global support to empower civil society organizations across 20 African countries. This initiative aims to lead advocacy campaigns surrounding Universal Health Coverage by fostering awareness about health financing, delivering comprehensive CSO training, and dispelling unfounded rumors and misconceptions.

Barrister Ayo Adebusoye, a board member of LASHMA, emphasized the significance of the baseline assessment regarding the state’s alignment with the NHIA Act 2022. He stressed that this evaluation plays a crucial role in ascertaining the extent to which states adhere to the provisions outlined in the NHIA Act 2022.