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.
“The fact that the NHI was even signed into law is not as a result of the benevolence of the government or its wisdom but a victory of popular working-class struggles that put pressure on the African National Congress (ANC) and the government’s political apparatus to realise this strategic objective of the national transformation.”
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.
He argued that the suspension of the NHI is a political choice rather than a court-imposed necessity.
“The failure of the government to implement the NHI is a political choice of the president and his government and not a random circumstance forced upon him by court proceedings against the scheme,” he said, linking the decision to broader neoliberal and austerity policies within the government.
“This halting of the implementation of NHI is tantamount to a reversal of a key important transformative policy. An important era of a new public health policy has been reversed before it is born in reality,” Mandlana added.
He warned that the move undermines the vision of ending South Africa’s “unequal two-tiered healthcare regime.”
He further stated that the party remains firmly committed to the core principles of the NHI, emphasising that it will continue to defend them and uphold the need for progressive redistribution of wealth to ensure quality universal healthcare for all, particularly the working class.
Mandlana is calling on progressive forces and workers nationwide to oppose the government’s decision, stating: “In our rejection of the reversal of the NHI, we call on all progressive forces across the board to resist this latest move by the government. We call upon workers in healthcare specifically and workers across the country to join us in rejecting this abhorrent decision. The struggle for an equitable healthcare system continues. The unity of the working class is pivotal in this struggle.”
The Star
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