In a letter from the Office of State Attorney (20 Feb 2026) President Cyril Ramaphosa formally announced that no part of NHI Act will be put into operation until the Constitutional Court (ConCourt) has ruled on two challenges focused on public participation. – Business Day 2026
The letter states the President “undertakes not to promulgate any provisions of the NHI Act” before judgment is handed down in the public participation matters.
This implies that the law remains on the statute book, but implementation is paused.
The Board of Healthcare Funders (BHF) and the Premier of the Western Cape’s cases against the Act will be heard Con Court in the from 5 to 7 May 2026
“This pause reduces immediate regulatory uncertainty for funders, hospital groups, and clinicians. It also delays any operational deadlines that would have followed the commencement of sections of the Act. But it does not remove longer-term strategic risk. Boards still need scenario plans for different legal outcomes. “
“For now, healthcare leaders should watch three signals: the May hearing, any further court directions on the consolidation of challenges and signs of whether Government pivots towards alternative reforms while the NHI Act implementation remains on hold.”
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