Lagos sets December 31 deadline for mandatory health insurance

Lagos State residents, employers and workers have until December 31, 2026 to obtain health insurance cover. From January 1, 2027, the state will begin enforcing compulsory health insurance under Executive Order EO/BOS/01 of 2024, signed in July 2024.

Punch and Nairametrics reported that Governor Babajide Sanwo-Olu announced the timeline on Tuesday, while Vanguard reported the announcement was made on Wednesday. The governor flagged off the enforcement at an event in Victoria Island, where he also unveiled the Lagos Private Health Plans (LPHP). The new plans are meant for salaried workers and corporate organisations, while the existing Ilera Eko scheme continues to serve vulnerable residents and people in the informal sector.

According to a statement from the Office of the Special Adviser to the Governor on Media and Publicity, the aim is to ensure every Lagos resident can get quality healthcare without financial hardship. The order places duties on individuals, employers and the government.

Sanwo-Olu said employers should treat workers' healthcare as a necessary cost of doing business, just as they provide for pensions and other obligations. He also said no health provider should turn away a patient needing emergency care over money, and that patients must be stabilised first before payment or insurance questions are raised.

"We want compliance, not unnecessary confrontation," the governor said, urging employers and workers to use the grace period to pick a plan and register.

What it costs and who is covered

The state has not published the premiums in these reports. Government officials said operational guidelines would spell out contributions, minimum benefit packages and the responsibilities of participating organisations. Enrolment will be supported through a digital platform, which Sterling Bank helped develop as a technology and financial partner, according to the bank's vice president for government banking, Adewale Adebowale.

Twenty-one health maintenance organisations (HMOs) have signed up for the private plans, and the state said they are accredited by the National Health Insurance Authority (NHIA). Sanwo-Olu said the state will monitor how promptly HMOs pay hospitals and settle claims.

The Chairman of the Lagos State Health Management Agency (LASHMA), Dr Adebayo Adedewe, said the Health Equity Fund has been raised from ₦1 billion to ₦3 billion. The fund is meant to cover more than 500,000 vulnerable residents who cannot afford premiums.

Commissioner for Health Prof. Akin Abayomi said new technology, including artificial intelligence and modern diagnostic equipment, has pushed up the cost of care. He said out-of-pocket payment puts heavy pressure on families and hospitals, and that insurance spreads the cost across many people.

Lagos is targeting a rise in insured residents from about two million to at least 10 million. Citing NHIA data, the Permanent Secretary at the Lagos State Ministry of Health, Dr Dayo Lajide, said out-of-pocket payments made up 58 per cent of Nigeria's total health spending in 2024.

What happens next

The state has set up a Lagos Private Health Plan Implementation Steering Committee and an Enforcement Task Force. LASHMA said it is running radio, billboard and digital campaigns, and working with traditional rulers, market associations and transport unions to reach residents.

Market and medical leaders at the event asked for transparent implementation, timely payment to hospitals and fair accreditation. Dr Raymond Kuti of the Guild of Medical Directors said public trust would decide whether the scheme succeeds.