By Idris Muhammed Abdullahi
For many Nigerians, the National Health Insurance Authority (NHIA) formerly the National Health Insurance Scheme (NHIS) was created to serve as a lifeline. A system meant to shield citizens from the crushing costs of healthcare. A safety net. A national commitment to public health equity.
But for Idris Muhammed Abdullahi , a young professional and father based in Abuja , and millions like him across Nigeria, the NHIA has become a symbol of frustration, inefficiency, and institutional betrayal.
Idris’s story is not an isolated case , it is a mirror of a much deeper rot within an agency that was rebranded, legislatively reformed, and yet remains unchanged in its failure.
A System That Doesn’t Work: Idris’s Experience
Two years ago, Idris made a simple, lawful request: to update his NHIS records and replace his former beneficiary with his current beneficiary , something vital as they were preparing for a child. Despite his employer’s consistent remittance of health insurance premiums on his behalf, what followed was a nightmarish odyssey of red tape, silence, and administrative incompetence.
To this day, despite multiple follow-ups, his wife remains excluded from the system, leaving Idris to shoulder private healthcare costs in an economy already burdened with high inflation, soaring energy prices, and increased commensurate taxation.
This experience is a glaring example of how bureaucratic dysfunction at NHIA directly harms Nigerian families. And Idris is far from alone.
A National Health Insurance That Fails to Insure
Across the country, similar stories abound:
Enrollees are denied access to care, often at moments of crisis.
Hospitals under NHIA routinely dispense unbranded or substandard medications, and essential drugs are frequently unavailable, forcing patients to pay out-of-pocket.
Claims are delayed. Complaints are ignored. Accountability is non-existent.
Even worse, NHIA coverage routinely excludes basic medical services, defeating the very essence of “insurance.”
Meanwhile, funds continue to be deducted, and billions of naira continue to be funneled into a scheme that offers little more than paperwork and excuses.
The Promise vs. the Reality
The 2021 law establishing the NHIA was heralded as a turning point , a reformed, modernized institution focused on transparency and service delivery. But despite its rebranding, the NHIA continues to exhibit the same bureaucratic arrogance, inefficiency, and neglect that characterized the defunct NHIS.
The gap between policy and practice, budget and benefit, has grown wider.
While health insurance is meant to protect Nigerians from financial hardship during illness, it has become yet another source of hardship.
A Clarion Call to the President and National Assembly
We, concerned citizens, healthcare professionals, and advocates of public accountability, now issue this urgent plea:
Restructure or Scrap the NHIA. Sanction Failure. Compensate Victims. Reform Now.
What Must Be Done Immediately
1. Executive Action by the President
Order an independent audit of the NHIA financial, operational, and administrative.
Sack all underperforming executives and staff involved in systemic failures and replace them with competent, compassionate professionals.
Mandate the inclusion of feedback mechanisms and redress structures that respond to the needs of enrollees in real time.
2. Legislative Oversight and Action by the National Assembly
We call on the Senate and House Committees on Health, Public Accounts, and Anti-Corruption to:
Summon NHIA leadership for public hearings on service failure and fund management.
Amend the NHIA Act to include:
Statutory service delivery benchmarks, with job-loss consequences for failing to meet them.
Legal standing for enrollees to sue for service denial or administrative negligence.
Mandatory public disclosure of NHIA budgets, expenditures, and enrollee coverage data, published quarterly.
Creation of a Health Insurance Victims Compensation Fund to address lives lost, children orphaned, and families impoverished due to NHIA’s negligence.
Administrative sanctions and criminal penalties for mismanagement, negligence, and fraudulent provider collaborations.
Whistleblower protections and an independent ombudsman for complaints handling.
Basic Healthcare is a Right, Not a Privilege
This is not just about bureaucratic lapses , it is about life and death. When a public institution meant to guarantee access to healthcare becomes a gatekeeper of suffering, it has forfeited its right to exist in its current form.
Nigerians are already battling with poverty, inflation, insecurity, and unemployment. They cannot also be expected to fight for access to a health insurance scheme they are already paying for.
Enough is enough.
A New Health Insurance Era or Nothing
The NHIA has lost public trust. The only path forward is through bold reform, clean leadership, and clear accountability. If these cannot be guaranteed, then let the agency be scrapped entirely, and let a new institution rise from its ashes , one built on efficiency, equity, and empathy.
Let this call reach:
The President
Hadiza Bala Usman, SA to the President on Policy and Coordination
The Speaker and Senate President
The Ministers of Health and Justice
And every Nigerian who still dares to believe in a country where public health is treated not as a privilege, but as a right.
We demand action.
We demand justice.
We demand a health insurance system that works or none at all.
This article is inspired by the experience of Idris Muhammed Abdullahi, a public servant and public analyst in Abuja, and millions of silent victims across Nigeria. May their voices no longer be ignored.
