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Targets 10m enrollees as 21 HMOs join private health plan
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By Doris Obinna
The Lagos State Government has given employers, workers and residents until 31 December 2026 to obtain appropriate health insurance coverage, warning that enforcement of mandatory health insurance will begin on 1 January 2027.
Governor Babajide Sanwo-Olu announced the deadline on Tuesday during the launch of the Lagos Private Health Plan (LPHP) Partnership at Lagos Continental Hotel, Victoria Island, where 21 Health Maintenance Organisations (HMOs) were unveiled as participating partners.
He said the initiative, anchored on Executive Order EO/BOS/01/2024 signed on 16 July 2024, was designed to expand health insurance coverage, reduce out-of-pocket healthcare spending and ensure residents could access medical services without depending solely on their ability to pay when ill.
Sanwo-Olu explained that the new plan would complement the existing Ilera Eko scheme, which primarily supports vulnerable populations and informal-sector workers, by providing additional options for salaried employees and corporate organisations.
He disclosed that actuarial analysis of about two million claims and enrolment records informed the development of the LPHP.
The governor said the state had established an implementation steering committee and enforcement task force to ensure compliance, urging residents and employers to use the grace period to complete registration.
“We want compliance, not unnecessary confrontation,” he said, adding that contributions would also support the Lagos State Health Equity Fund and public healthcare infrastructure.
He assured stakeholders that the government would monitor participating HMOs, particularly their prompt payment to healthcare providers, claims settlement and access to appropriate treatment.
Commissioner for Health, Prof Akin Abayomi, described the initiative as a major shift in healthcare financing, saying dependence on out-of-pocket payments could push families into debt or force them to exhaust their savings when illness occurs.
He said mandatory participation would create a sufficiently large insurance pool, spreading healthcare costs across the population and promoting solidarity between healthy and sick residents, younger and older people, and those able to contribute and vulnerable households.
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Abayomi said Lagos was targeting an increase in insured residents from about two million to at least 10 million. He added that the National Health Insurance Authority (NHIA) had accredited participating organisations.
Special Adviser to the Governor on Health, Dr Kemi Ogunyemi, said the Executive Order provided the legal framework for compulsory health insurance and required public and private employers to provide coverage for their workers.
She said the partnership would allow individuals, families and employers to choose from accredited plans, stressing that the initiative was intended to improve affordability and service quality rather than penalise HMOs and private healthcare providers.
Chairman, Governing Board, Lagos State Health Management Agency (LASHMA), Dr Adebayo Adedewe, said the agency had intensified public sensitisation through radio, billboards, digital campaigns and engagements with traditional rulers, market associations, transport unions and community leaders.
He disclosed that funding for the Lagos State Health Equity Fund had risen from N1 billion to N3 billion, with a target of enrolling 500,000 vulnerable residents.
Permanent Secretary, Lagos State Ministry of Health, Dr Dayo Lajide, cited a National Health Insurance Authority report indicating that out-of-pocket payments accounted for 58 per cent of Nigeria’s total health expenditure in 2024. She said expanding insurance coverage would help protect households from financial hardship.
Permanent Secretary of LASHMA, Dr Emmanuella Zamba, described the launch as a transition from policy development and stakeholder engagement to implementation, urging sustained collaboration among government agencies, insurers and healthcare providers.
Vice-President, Government Banking, Sterling Bank, Adewale Adebowale, said the bank was supporting the initiative as a technology and financial partner. He said its digital platform would facilitate enrolment and make it easier for employers to register workers.
National President, Healthcare Providers Association of Nigeria, Dr Aipoh Augustine, commended the government for consulting stakeholders but called for transparent implementation, timely reimbursement, simplified payment procedures and fair accreditation processes.
Meanwhile, National President, Guild of Medical Directors, Dr Raymond Kuti, said transparency and accountability would be crucial to building public trust, urging the government to sustain engagement with private healthcare providers.
Similarly, immediate past President of the Health and Managed Care Association of Nigeria, Dr Leke Oshunniyi, said an effective insurance system would ensure healthcare providers received payment for services rendered while reducing patients’ financial burden.
The state government said operational guidelines would specify contributions, minimum benefit packages and the responsibilities of participating organisations ahead of the 1 January 2027 enforcement date.
