Lagos begins mandatory health insurance enforcement January 2027

By Olasunkanmi Akoni Lagos State Governor, Mr Babajide Sanwo-Olu, has given residents, employers and workers until December 31, 2026, to obtain health insurance coverage ahead of the enforcement of mandatory health insurance in the state from January 1, 2027. Sanwo-Olu announced the deadline on Tuesday while unveiling the Lagos Private Health Plans (LPHP), designed to extend health insurance coverage to salary earners and corporate organisations.

The initiative, launched under Executive Order EO/BOS/01/2024, is expected to complement the existing Ilera Eko scheme, which provides subsidised healthcare coverage for vulnerable residents and those in the informal sector. The event was attended by healthcare practitioners and other stakeholders from the public and private sectors, including health maintenance organisations (HMOs), healthcare providers, government officials and representatives of health institutions.

The governor said the policy was designed to change how residents finance medical treatment and prevent illness from plunging families into financial hardship. “Every resident, every employer, and every worker in Lagos is required to have social health insurance,” he said, adding that the executive order placed responsibilities on individuals, employers and the government.

Sanwo-Olu noted that many families struggled to pay hospital bills from the same income needed to cover rent, school fees and other essential expenses. He said the new arrangement would enable residents to access medical care without having to pay the full cost of treatment out of pocket. “When that mother walks into the hospital in Lagos State next year, she will show her card.

She will receive care, and she will keep her money for her journey back home. “And that father will take his child to the hospital without being worried or scared that where is the payment going to come from?” the governor said. Explaining the distinction between the two schemes, Sanwo-Olu said Ilera Eko catered to vulnerable residents and people in the informal sector, while the new private health plans were designed for the formal workforce.

“Ilera Eko serves the informal sector and the vulnerable. The Lagos Private Health Plans will serve the formal sector. There is now a plan offered by the state for every Lagosian, be it formal, be it informal, be it vulnerable,” he said. According to the governor, licensed actuaries reviewed nearly two million claims and enrolment records to determine the cost of providing health insurance for the formal sector.

He added that 21 health maintenance organisations had endorsed participation in the new plans, describing the arrangement as a partnership between the state government and private operators to expand insurance coverage and strengthen healthcare delivery. Sanwo-Olu announced a moratorium until December 31, 2026, to give residents and employers time to enrol before enforcement begins in January 2027.

“I truly, truly want compliance. I don’t want a horse whip for anybody. I want people to go out there and let us have free compliance,” he said. The governor also announced the establishment of an implementation steering committee and an enforcement task force to coordinate the rollout and ensure compliance across the state. He said the government would monitor participating HMOs, particularly the speed of hospital payments, settlement of claims and whether patients received the treatments covered by their insurance plans.

“At least 70 kobo of every naira of premium paid that you collect must be spent on care,” Sanwo-Olu said, adding that the government would publish quarterly monitoring results. He explained that contributions from the private health plans would also support the Lagos State Health Equity Fund, which provides coverage for residents unable to afford insurance premiums.

Other contributions, he said, would support the provision of drugs and equipment, as well as staffing, in public health facilities. The governor said the government would ensure transparency and timely payments to healthcare providers. “Every hospital should be paid on time, every naira that enters the system should be accounted for in public,” he said.

Sanwo-Olu also urged medical professionals considering emigration to reconsider, arguing that improved healthcare financing could strengthen the sector and make it more sustainable for practitioners. “We’re restoring dignity, viability, and credibility in the health sector,” he said, appealing to Nigerian doctors who had relocated abroad to consider returning to contribute to the country’s healthcare system.

Also speaking, Lagos State Commissioner for Health, Prof. Akin Abayomi, said advances in medical technology, including artificial intelligence, robotic science and modern diagnostic equipment, had significantly increased the cost of healthcare delivery. He stressed the need for a strong and inclusive health insurance system to protect residents from rising medical expenses while imp