NHIA pushes Parliament to update health insurance laws for Free Primary Healthcare rollout

The National Health Insurance Authority (NHIA) is pressing Parliament to amend the legal framework governing Ghana's health insurance system to accommodate President John Dramani Mahama's Free Primary Healthcare initiative, which was launched on 15 April 2026. Dr Kwesi Djokoto, Deputy Chief Executive Officer of the NHIA, told Parliament's Health Committee that the current National Health Insurance Act, 2012 (Act 852), requires substantial updates to support new financing arrangements and strengthen safeguards against fraud and patient exploitation.

The Free Primary Healthcare programme aims to provide essential first-contact medical services without charge at the point of use through facilities including CHPS compounds, health centres, polyclinics, public health units, community pharmacies and mobile health kiosks in markets and transport hubs. However, implementing this initiative effectively requires legal changes to the insurance authority's mandate and operating procedures.

Addressing fraud and ensuring accountability

A central concern driving the NHIA's reform push is the persistent problem of unauthorised charges and fraudulent claims within the health system. Dr Djokoto outlined plans to establish an anti-fraud and illegal payments directory designed to detect and prevent unauthorised charges, including illegal co-payments that undermine free healthcare access. The authority is also implementing artificial intelligence and digital verification tools to identify fraudulent claims, spot discrepancies between service tariffs and available funding, and catch billing irregularities.

The NHIA has already moved to electronic claims processing with a 20-day turnaround time for reimbursements to healthcare providers, delivering monthly payments to improve cash flow. Dr Djokoto called on Parliament to strengthen penalties for fraud and illegal co-payments and support the proposed legal amendments as essential infrastructure for the new healthcare model.

Why it matters for Ghana

The Free Primary Healthcare initiative represents one of the Mahama administration's flagship health policies, designed to remove financial barriers to basic medical care and preventive services at the community level. However, the scheme's success depends entirely on preventing leakage, combating fraud and ensuring that funds reach genuine healthcare delivery rather than disappearing through corruption or unauthorised charges.

For ordinary Ghanaians, this means the difference between receiving promised free care or facing hidden co-payments and illegal charges. For healthcare workers and facilities, legal clarity ensures sustainable reimbursement and fair compensation. The NHIA's emphasis on updating the legal framework reflects lessons from previous health insurance reforms—that policy initiatives without adequate legal backing and enforcement mechanisms often fail to deliver promised benefits. Without amendments to Act 852, the free primary healthcare programme risks becoming another initiative undermined by systemic loopholes and administrative obstacles. Parliament's support for these reforms is crucial for translating the government's healthcare vision into tangible improvements for Ghana's most vulnerable populations, who rely heavily on primary healthcare facilities for routine care, maternal and child health services, and disease prevention.