HMOs challenge Lagos government’s claim on health plan support

Health Maintenance Organisations (HMOs) from two industry groups have rejected the Lagos State government's claim that 21 HMOs supported its new Lagos Private Health Plan (LPHP).

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

They pointed out that individual HMOs attending consultations or the launch does not mean they collectively endorse the plan. They also mentioned that the plan must be approved by the National Health Insurance Authority (NHIA) before it can go into action.

This response came after the state government launched the LPHP and announced a deadline of 31 December 2026 for residents, employers, and workers to get health insurance.

At the launch in Lagos on Tuesday, Governor Babajide Sanwo-Olu said 21 HMOs were involved in the new scheme. The government claims this plan aims to widen health insurance coverage, especially for formal-sector workers and businesses.

But HMCAN and AHIPN said that just because an HMO is accredited does not mean a specific health plan is approved.

“Attendance at the launch, consultations, or expressions of interest by individual HMOs do not constitute HMCAN’s and AHIPN’s endorsement,” the associations said. They want corrections made to reports that suggest a collective endorsement from the industry.

The associations support the federal government’s push for universal health coverage and the goal of the Lagos State Executive Order on mandatory health insurance.

However, they believe that the implementation must be lawful, affordable, and well-coordinated.

According to the groups, a statement issued after talks between the NHIA and Lagos State in October 2025 recognized the NHIA as the official regulator. They noted that participation by HMOs in the Lagos plan is voluntary.

The framework allows employers to choose NHIA-approved plans, and it requires health plans to get prior approval from the authority.

The associations are calling for the publication of the NHIA approval documents. They also raised concerns about the tax on private-sector health insurance.

“Our understanding is that the framework includes a total 13 percent tax on private-sector health insurance. Its legal basis and details need to be clear.

“If this is added to current premiums and obligations, HMCAN and AHIPN see it as an extra burden and a form of double taxation on employers who are already paying for healthcare. Extra charges should not reduce what is available for patient care,” they said.

The groups warned that if the tax is applied on top of existing costs, it could raise expenses for employers and limit funds for patient care.

They also said employers have not received enough guidance on what health insurance coverage is acceptable, what minimum benefits must be included, certification requirements, and potential penalties.

The associations called for recognition of current NHIA-approved health insurance coverage without forcing employers or workers to pay or enroll again.

Lagos State insists that health insurance is mandatory for residents based on an Executive Order signed by Mr Sanwo-Olu in July 2024.

The state government said the new private health plan aims to give formal-sector employees and companies another way to get coverage, in addition to the existing Ilera Eko scheme.

The deadline for residents, workers, and employers to secure proper coverage is set for 31 December 2026, with enforcement starting on 1 January 2027.

The Commissioner for Health, Akin Abayomi, said the goal is to raise the number of insured residents from about two million to at least 10 million.

The government claims the policy aims to reduce the need for out-of-pocket payments for healthcare.

The plan is also expected to provide more stable payments to healthcare providers and expand access to care.

HMCAN and AHIPN, though, want the government to review the 31 December deadline. They argue that employers need enough notice, clear guidelines, and a realistic transition period before enforcement starts.

The associations have called for an urgent meeting with the Lagos State Government, LASHMA, NHIA, employers, healthcare providers, labor, and other stakeholders to address these issues and agree on a phased rollout.