By Folasade Akpan
The Managing Director of SUNU Health Nigeria Ltd., Dr Moyosore Olomola, has called for stronger legislation to expand health insurance coverage and accelerate the attainment of Universal Health Coverage (UHC) in Nigeria.
Olomola made the call in an interview with the News Agency of Nigeria (NAN) on Sunday in Abuja.
He said achieving UHC required closer collaboration among the National Health Insurance Authority (NHIA), private Health Maintenance Organisations (HMOs), healthcare providers and lawmakers.
According to him, Nigeria’s 22 million health insurance enrollees remain well below the NHIA’s target of 44 million beneficiaries by 2030.
Olomola said the relationship between the NHIA and private HMOs should evolve beyond regulation into a genuine partnership to strengthen healthcare financing and improve access to quality services.
“The Authority has made significant strides in professionalising the regulatory space through its accreditation framework, enforcement of minimum capital requirements for HMOs and ongoing digitisation of its processes.
“HMOs are not the NHIA’s adversaries; we are the delivery infrastructure for UHC. Without a sustainable private HMO sector, government cannot achieve its target of 44 million enrolled lives by 2030,” he said.
He called for a transparent tariff review mechanism linked to healthcare inflation, stronger enforcement of mandatory employer enrolment under the NHIA Act and predictable funding through the Basic Health Care Provision Fund.
Olomola also advocated a formal dispute resolution mechanism between HMOs and the NHIA to address disagreements and strengthen collaboration.
Olomola also advocated legislation establishing a provider accountability framework, saying healthcare providers that deny services to insured patients or demand unauthorised payments undermine public confidence in the health insurance system.
“Providers who deny services to enrolled beneficiaries, demand deposits from HMOs or otherwise operate outside the agreed regulatory framework must face defined sanctions, including suspension from NHIA accreditation and public reporting.
“At present, the consequences are insufficient to change behaviour, and that impunity is damaging the entire scheme,” he said.
He said the proposals were presented during a recent engagement with the Chairman of the House of Representatives Committee on Health Services, Hon. Amos Magaji, to seek legislative support for removing barriers to health insurance expansion.
According to him, although the NHIA has made notable progress in expanding coverage, structural challenges, including funding gaps, inadequate premium models for the informal sector, uneven state commitment and poor provider compliance, continue to slow enrolment.
“We asked the committee to support legislative and regulatory measures that will hold errant providers accountable through sanctions, delisting and public reporting.
“When an enrollee arrives at a hospital and is turned away or made to pay out of pocket despite being on a valid scheme, it destroys trust in the entire system,” he said.
Olomola commended the NHIA for reforms such as tariff reviews, state-level domestication of health insurance laws and stronger engagement with private HMOs, describing them as important foundations for expanding coverage.
“The obstacles are structural, not attitudinal. When the product is accessible, affordable and claims are settled promptly, people enrol and renew,” he said.
He said about 80 per cent of Nigeria’s workforce earned irregular, seasonal or cash-based incomes, making conventional monthly or annual premium models unsuitable for many.
According to him, SUNU Health is addressing the challenge through community-based enrolment involving trade associations, cooperatives and religious organisations.
He said the initiative also includes weekly USSD micro-premium payments, hybrid catastrophic health cover and telemedicine services through the company’s partnership with MobiHealth.
“Our partnership with MobiHealth extends our digital reach and enables telemedicine access for enrollees who may not be near a physical provider.
“A trader in Aba can consult a physician on her phone and obtain a prescription from a partner pharmacy. That is accessible, affordable and convenient,” he said.
Olomola noted that Nigeria’s out-of-pocket health expenditure remained above 70 per cent of total health spending, highlighting the need for a unified national health insurance database, stronger state financing, digital claims processing and greater transparency across the sector.
“Nigeria has the demographic foundation, the regulatory architecture and growing political will to achieve UHC.
“What is needed now is disciplined execution and a private sector that sees itself as a genuine partner in a national health mission, not merely a commercial operator in a regulated market,” he said. (NAN) www.nannews.ng
Edited by Tosin Kolade