The National Health Insurance Authority (NHIA) says it has recorded significant progress in expanding health insurance coverage and protecting Nigerians from catastrophic healthcare costs through strengthened nationwide implementation of mandatory health insurance.
This is contained in the Authority’s year-end review, made available to reporters on Sunday in Abuja.
The review highlighted key milestones achieved under ongoing reforms aimed at improving enrollment, service delivery and financial protection in the health sector.
According to the report, the enforcement of mandatory health insurance has shifted more Nigerians away from out-of-pocket payments for healthcare to organized prepayment through insurance schemes.
“By the third quarter of 2025, more than 21 million Nigerians had been enrolled in health insurance through collaboration between the NHIA, State Social Health Insurance Agencies and Health Maintenance Organizations,” the Authority said.
It noted that a major turning point came with the Presidential directive mandating health insurance for all Ministries, Departments and Agencies, as well as requiring valid NHIA insurance certification for participation in public procurement and the renewal of federal licenses.
The Authority said the measure was accelerating coverage across the formal sector, organized private sector, and micro, small and medium-sized enterprises.
The report also highlighted equity-focused programmes such as the NHIA Comprehensive Emergency Obstetric and Newborn Care initiative, which ensures zero out-of-pocket payment for emergency maternal and newborn care, and the Fistula-Free Programme, which provides treatment for women living with obstetric fistula.
According to NHIA, these initiatives are supporting the enrollment of vulnerable women and children into health insurance schemes.
The Authority further disclosed that the completion of a comprehensive actuarial evaluation in 2025 provided a scientific basis for reviewing provider payment rates.
This review resulted in a 93 per cent increase in capitation rates and a 378 per cent rise in fee-for-service tariffs, aimed at improving service quality and ensuring sustainability.
The report also noted that governance structures were strengthened with the inauguration of the NHIA Governing Council in 2025 to provide oversight and ensure alignment with national Universal Health Coverage goals.
It added that a national policy dialogue on healthcare financing was convened with key stakeholders to explore sustainable funding options and expand domestic financing for health.
NHIA said the reforms align with the Federal Government’s broader health sector agenda of reducing out-of-pocket spending, protecting citizens from financial hardship and improving access to quality healthcare.
The NHIA Act mandates that all Nigerians be covered under a health insurance scheme, with the Authority serving as the national regulator responsible for coordinating insurance-based healthcare financing across the country.

