DODOMA – A BILL that seeks to amend the National Health Insurance Fund Act came into the House for the First Reading.
Cited as the National Health Insurance Fund (Amendment) Bill, 2025, the proposals intend to amend the National Health Insurance Fund Act, Cap 395 to align it with the Universal Health Insurance Act, No 13 of 2023 and to address challenges that have been encountered during the implementation of the Act.
The National Health Insurance Fund Act was enacted in 1999 to provide for the establishment of the National Health Insurance Fund for the sustainable healthcare system in Tanzania Mainland.
Since its enactment, the Act has been amended nine times with the view to ensuring compliance with sectoral and technological changes, social security requirement as well as compliance with regional and international requirements and standards.
The Bill now intends to widen the scope of beneficiaries under the Fund as opposed to current position where coverage is limited to certain public servants.
The proposed amendments grant the President the authority to appoint the Director General instead of the Board. The purpose of this amendment is to ensure good governance and accountability in the management of the Fund.
The Bill amends Section 8 of the National Health Insurance Fund Act, Cap 395 to accommodate other categories of persons to be registered with the Fund instead of registration of government employees only.
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The purpose of the amendment is to widen the scope of membership in line with the requirements under the Universal Health Insurance Act. The Bill also amends Section 9 of the NHIF Fund Act to specify the contribution rates to the Fund and the obligation of all registered members of the Fund.
Currently, the law does not provide contribution rates for certain members, including contributors from the formal private sector and some contributors from the public sector.
Further, the section proposes that the contribution system for the informal sector be conducted in accordance with the Universal Health Insurance Act.
The purpose of the amendment is to ensure more members join the health insurance scheme. Section 10 of the Act is proposed to be amended to mandate the minister, upon recommendation by the Board, to review rates of contribution to the Fund and such rates shall be by notice published in the Government Gazette.
The purpose of the amendment is to facilitate the ease of adjusting contribution rates due to various reasons. Section 11 of the Act (NHIF Fund Act) is proposed to be amended by widening the scope of coverage of beneficiaries.
The current position leaves out other categories of members such as indigents, the informal sector and other categories of persons from being members of the scheme.
The purpose of the amendment is to widen coverage of beneficiaries and align the provisions of this section with the Universal Health Insurance Act. Section 14 is proposed to be amended to include persons or group of persons who were not covered under the Act.
The purpose of the amendment is to widen the scope of membership and align with provisions of the Universal Health Insurance Act. Section 15 is proposed to be amended to recognise other forms of identification.
The purpose of the amendment is to simplify identification process through other means including electronic identification.
The section is also amended to impose an obligation on the employer, member, beneficiary, the member’s relatives and health service providers to report the termination of membership or benefits for any reason by collecting and submitting such identification to the Fund. Furthermore, the section is amended by increasing the age of a child from eighteen to twenty-one years.
The purpose of the amendment is to align the section with the definition of the term “child” for purposes of health insurance coverage.
Sections 19, 20 and 23 of the Act are proposed to be amended by removing the requirement for accreditation of health care providers by the Fund, instead the Fund will undertake certification of health care providers who are accredited by the Ministry of Health.
Section 21 is proposed to be amended in order to empower the Board to vary criteria for certification of health service provider on the basis of other intervening circumstances other than geographical circumstances.
The purpose of the amendment is to allow flexibility of beneficiaries to choose a health care provider in areas where there are limited health care services.
The Bill also amends Section 32 of the Act (National Health Insurance Fund Act, Cap 395 ) to include contribution from other sources which were not covered under the Act.
The purpose of the amendments is to incorporate contributions from formal private sector and informal sector with the view to ensure sustainable and quality provision of health insurance services.
