HMOs dispute Lagos govt’s endorsement claim over private health plan

Health Maintenance Organisations (HMOs) under two industry associations have disputed the Lagos State government’s claim that 21 HMOs endorsed its newly launched Lagos Private Health Plan (LPHP).

The Health and Managed Care Association of Nigeria (HMCAN) and the Association of Health Insurance Practitioners of Nigeria (AHIPN) made their position known in a statement signed by their chairmen, Abdulkadri Osumah and Ben Okpalla, respectively.

They noted that participation by individual operators in consultations or the launch does not amount to collective endorsement, and the plan requires approval from the National Health Insurance Authority (NHIA) before implementation.

Their reaction followed the state government’s launch of the LPHP partnership and announcement of a 31 December 2026 deadline for residents, employers and workers to obtain health insurance.

At the launch in Lagos on Tuesday, Governor Babajide Sanwo-Olu said 21 HMOs were participating in the new arrangement, which the government said is designed to expand health insurance coverage, particularly among formal-sector workers and corporate organisations.

But HMCAN and AHIPN said accrediting an HMO is different from approving a specific health plan.

“Attendance at the launch, consultations or expressions of interest by individual HMOs do not constitute HMCAN’s and AHIPN’s endorsement,” the associations said, requesting corrections to reports suggesting collective industry endorsement.

The associations said they support the federal government’s drive towards universal health coverage and the objectives of the Lagos State Executive Order on mandatory health insurance.

However, they said implementation should be “lawful, affordable and properly coordinated.”

According to the groups, a communique issued after discussions between the NHIA and Lagos State in October 2025 recognised the NHIA as the statutory regulator, while HMO participation in the Lagos plan is voluntary.

They said the framework also provided for employers to choose NHIA-approved plans and required health plans to obtain prior approval from the authority.

The associations therefore called for the publication of the relevant NHIA approval documents. They also raised concerns about the levy on private-sector health insurance arrangements.

“Our understanding is that the framework includes an aggregate 13 per cent levy (Tax) on private-sector health insurance arrangements. Its legal basis, calculation base and components require clarification.

“If imposed in addition to existing premiums and statutory obligations, HMCAN and AHIPN consider it an unnecessary burden and a form of double taxation on employers already funding healthcare. Additional charges must not erode affordability or funds available for patient care,” it noted.

The groups warned that if the levy is imposed alongside existing premiums and statutory obligations, it could increase costs for employers and reduce funds available for patient care.

They also said employers have not received sufficient guidance on acceptable health insurance coverage, minimum benefits, certification and possible sanctions.

The associations called for existing NHIA-approved health insurance coverage to be recognised without requiring employers or workers to enrol or pay twice.

Lagos State has maintained that health insurance is compulsory for residents under an Executive Order signed by Mr Sanwo-Olu in July 2024.

The state government said the new private health plan is intended to provide an additional route for formal-sector employees and organisations to obtain coverage, alongside the existing Ilera Eko scheme.

The government has given residents, workers and employers until 31 December 2026 to obtain appropriate coverage, with enforcement scheduled to begin on 1 January 2027.

The Commissioner for Health, Akin Abayomi, said the state was targeting an increase in the number of insured residents from about two million to at least 10 million.

The government has said the policy is aimed at reducing reliance on out-of-pocket healthcare payments.

According to the state, the plan would also provide more predictable payments to healthcare providers and expand access to care.

HMCAN and AHIPN, however, want the government to review the 31 December deadline, arguing that employers need adequate notice, clear guidelines and a realistic transition period before enforcement and sanctions begin.

The associations called for an urgent meeting involving the Lagos State Government, LASHMA, NHIA, employers, healthcare providers, labour and other stakeholders to resolve the outstanding issues and agree on a phased implementation.