Cyril Ramaphosa to give reasons for signing NHI Bill into law

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The High Court has ruled that President Cyril Ramaphosa’s decision to sign the National Health Insurance (NHI) Bill into law is open to judicial review – and that he must submit a full record of the reasoning behind his decision within 10 days.

The ruling comes in response to legal action brought by the Board of Health Funders (BHF) and the South African Private Practitioners Forum (SAPPF), who argued that Ramaphosa acted irrationally by assenting to the bill in May 2024 despite widespread constitutional and legal concerns raised during the legislative process.

Reservations about its constitutionality

At the heart of the matter is whether the Ramaphosa fulfilled his constitutional obligation under Section 79(1) of the Constitution, which allows – and arguably requires – the president to refer a bill back to parliament if there are reservations about its constitutionality.

The BHF contends that, by signing the bill into law without doing so, Ramaphosa neglected that duty and set in motion what they describe as “vague, unaffordable, and unworkable” legislation.

Ramaphosa’s legal team had pushed back, arguing that his decision was part of his constitutional discretion and not subject to judicial oversight.

However, the court rejected that claim.

“The president’s decision to assent to and sign the NHI Bill is reviewable because all executive decisions are reviewable under the principle of legality or under Rule 53,” the court found.

The court held that assenting to legislation is not an isolated presidential act, but a step in the broader legislative process – and, therefore, subject to scrutiny.

Significant development

In its ruling, the High Court has ordered Ramaphosa to provide the complete record of the decision-making process – including documents and correspondence – in line with Rule 53 of the Uniform Rules of Court.

The ruling is a significant development in the ongoing battle over the NHI, a health reform initiative aimed at establishing universal health coverage.

While its supporters say it will improve healthcare access for all South Africans, critics argue it lacks financial feasibility, undermines private healthcare, and was rushed through without sufficient consultation.

The BHF hailed the ruling as a constitutional victory.

“No office-bearer, including the president, is above judicial scrutiny,” the organisation said in a statement.

It added that the court’s decision reaffirms that all public power is accountable to the rule of law.

The case now moves into its next phase, where the contents of Cyril Ramaphosa’s record may shed light on whether the signing of the NHI Bill was made with adequate consideration of public, legal, and policy concerns.