Nigeria: Lagos Reviews Health Scheme Law in Tandem With NHIA Act – Zamba

In line with its determination to improve the landscape of health insurance in Lagos, the Lagos State Health Scheme Law is being reviewed. The move is to ensure the Lagos State Health Insurance Scheme is in tandem with the National Health Insurance Authority Act (NHIA).

As part of moves to resolve the gray areas between the state’s Health Scheme and provisions of the NHIA Act, a draft law has been developed to repeal the current state law and align it with National law.

The Permanent Secretary of the Lagos State Health Management Agency, LASHMA, Dr. Emmanuella Zamba, who disclosed this in Lagos, said the National law mandates social plans for everyone, but the state law does not.

Zamba spoke in Lagos at the Joint Learning Agenda (JLA), stakeholder engagement event for the baseline assessment of the state’s health insurance act to be in alignment with the NHIA Act 2022.

At the meeting held with the Lagos Civil Society Participation for Development, LACSOP, the Joint Learning Agenda for Universal Health Coverage, JLA4UHC, the media, and other stakeholders, the permanent secretary said the goal is to ensure that everyone in Lagos has access to quality healthcare services without financial burden.

A review of the state law is necessary to address the gaps and ensure the smooth implementation of making health insurance mandatory in the state.

Zamba said, “The NHIA Act has a role, even though it is not a perfect document. There are gaps; we have gone through them, and we know that there are limitations as to the level of jurisdiction that the federal government has over state health insurance, which is on the concurrent list and also has its own legislative feedback.

“Part of the grey areas is: where does the federal government’s legislation start and where does it end, and where does the state’s legislation start?

“Certainly, we cannot be running a state health insurance scheme without regulating it. These are things that we have identified. The Lagos State Health Scheme Law should be revised to be more in tandem with the national law while we also look at our context.”

Further, Zamba noted that a draft for a law commission engagement had been raised and was awaiting the legislative principal’s name.

“A draft has been raised to engage the law commission; we are waiting for the legislature to tell us who our principal would be at the legislative level.”

In her narrative, the permanent secretary noted that operational guidelines are interpretations, not laws.

“When we say operational guidelines, states are not obliged to take a cue from the operational guidelines. It is not a law but an interpretation of how you want to implement it, and it is not by itself something that you have to adopt wholly.”

“You can take from it because you are part of the nation; you must adapt it to your own concept in your state. It would be counterproductive to think that having a one-size-fits-all solution would solve our problem,” she explained.

The Agency received 100 percent of the BHCPF in 2022 and 50 percent from the federal government in 2023.

During a presentation of the scorecard on demand generation for mandatory health insurance, Ms. Olayide Akanni, coordinator of the JLA4UHC, said the group is assessing compliance with the NHIA Act in Lagos and Kano states by identifying gaps, interventions, and support from civil society organizations. She noted that the JLA4UH, a civil society-led initiative, was initiated through support from global donors to build the capacity of civil society organizations across 20 countries in Africa in order to lead advocacy initiatives around Universal Health Coverage by developing advocacy for health financing, providing CSO training to understand insurance’s role, and raising awareness to dispel rumors and misconceptions.

A board member of LASHMA, Barrister Ayo Adebusoye, said the baseline assessment of the state alignment with the NHIA Act 2022 is crucial as it will help ascertain if states are in line with the provisions of the NHIA Act 2022.

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