Minister of Health Aaron Motsoaledi said there is a total of 15 cases challenging the National Health Insurance Act.
Image: National Department of Health / Facebook
No funds have been allocated to an advertising budget for the National Health Insurance (NHI), but R74 million has been set aside to defend legal challenges related to the new Act.
Health Minister Aaron Motsoaledi disclosed this in response to parliamentary questions from DA MP Michele Clarke and Freedom Front Plus MP Philip van Staden.
He said there are 15 cases currently challenging the NHI Act, with each case costing between R2.5 million and R3 million on average and running for more than a year.
Motsoaledi added that payments have been made to six senior counsel, 10 junior counsel, and attorneys involved in the litigation.
“Budgeted costs set aside in this regard for the 2026/27 financial year is R74m.”
Ten months ago, Motsoaledi was quoted as saying the department spent R9.1 million on litigation involving the NHI Act. This year's budget is allocated at a time the Constitutional Court is set to hear the legal challenge regarding the NHI and whether Parliament acted in accordance with the Constitution when it passed the NHI Act.
The matter will be heard next month from May 5 to May 7, and the Board of Healthcare Funders and the Western Cape Government are expected to argue that they were not properly consulted during the Bill’s development and the Act’s assent.
In February, President Cyril Ramaphosa delayed the proclamation of any section of the NHI amid the ongoing litigation.
Ramaphosa wants the Constitutional Court to hand down its judgment in court challenges due to be heard in May.
His decision came after consultations with Motsoaledi, who is also a co-respondent in the legal challenges that question the parliamentary public participation process that preceded the bill’s passage ahead of the 2024 general elections.
Ramaphosa is on record that the litigation will not disrupt the timeline for implementing the NHI or halt ongoing preparatory work by the Department of Health.
“This undertaking, which has been made an order of court, will not affect the timetable for the implementation of the NHI, nor will it stop the work currently underway. Work has been going on up to and including improving our infrastructure,” he said in Parliament recently.
Motsoaledi noted that the high court has since made an order, with the agreement of all parties, that all NHI-related cases will be stayed.
This is applied to the proclamation of all sections of the Act, including any implementation of the Act until the Constitutional Court has passed judgement on public participation challenges.
“The Department is continuing with the public health systems strengthening activities and the preparatory work for the NHI that are in the annual performance plan and budgeted for,” said Motsoaledi.
Meanwhile, the Department of Health said there is no dedicated advertising budget for the NHI in the 2026‑27 financial year.
“The department as a matter of course, and within its programmes communicates to the public. This includes communication on programmes such as HIV, TB, immunisations and so forth,” Motsoaledi said.
However, he said the advertising budget for NHI in the 2025/26 financial year was R7.8m as of February 28, 2026.
“The only NHI communication campaign is the ‘NHI Change Champions’ which is an information campaign to provide the employees of the various health departments and the members of the public who frequent public health facilities facts about what is contained in the NHI Act,” said Motsoaledi.
It was previously reported that department spent R28.4 million on NHI advertising from April 2024 until January 2025, drawing scrutiny and criticism from various stakeholders.
The department had maintained its commitment to promoting NHI, even as voices arise, urging a reallocation of funds to address other pressing health needs.