The Government is paying millions in legal fees to meet various legal challenges to the National Health Insurance (NHI) scheme – with a pivotal case being heard next month.

According to Health Minister Aaron Motsoaledi, government is facing 15 legal cases challenging the NHI, each costing the state between R2m and R3m to defend.

‘These cases have been going on for more than a year. The money has been paid to six senior counsels, 10 junior counsels and attorneys,’ he said. In total, the budgeted costs set aside for the legal challenges in 2026/27 amount to R74m, he added.

BusinessTech reports that Motsoaledi was responding to a parliamentary Q&A from FF Plus MP Philip van Staden, who asked what contingencies the Department of Health had in place in the event it lost any court cases.

The Minister said it was ‘unclear’ what was meant by this, adding only that the department would continue to strengthen activities and preparatory work for the NHI, which has already been budgeted.

The latest 2026 budget allocated around R9.3bn to the NHI for this purpose. This includes nearly R1.5 bn in direct NHI grants over the next three years, as well as over R7.8bn in ‘indirect’ NHI funding.

Motsoaledi noted that the High Court has made an order of the court an agreement between various litigating parties and the government to put several legal challenges on hold.

In return, the state would stay the proclamation of all sections of the NHI Act, as well as any implementation of the Act, until the Constitutional Court passed judgment in two cases. 

BusinessTech reports that these relate to the public participation processes, which are alleged to have been rushed, rubber-stamped, and disregarded critical inputs from the private healthcare industry.

The cases will be heard between 5 and 7 May 2026, with the Board of Healthcare Funders and the Western Cape Government challenging. Both parties argue that they were not properly consulted during the NHI Bill’s development and the Act’s assent.

Even if the state wins the Constitutional Court fight coming in May, the stay on the remaining court challenges will end, and they will then proceed. In this case, any adverse ruling against the litigants will likely lead to an appeal and further challenges, leaving the NHI laws under litigation for a long time.

BusinessTech notes that Motsoaledi told the Portfolio Committee on Health in March that this could see the NHI dragged into court for 15 to 20 years.

The department has been trying to get ahead of this eventuality by proposing to the courts that as many legal challenges as possible be rolled into a single umbrella case.

It said that the High Court cases were applications of ‘unprecedented volume, factual density and constitutional complexity’.

Full BusinessTech report