The Lagos State Government will begin enforcing compulsory health insurance for all residents from January 1, 2027.
Governor Babajide Sanwo-Olu announced the enforcement date on Tuesday at the unveiling of the state’s mandatory health insurance enforcement campaign in Victoria Island.
The event also saw the government introduce the Lagos Private Health Plus partnership, designed to bring private health maintenance organisations into the state’s universal health coverage programme.
Sanwo-Olu said the government would allow a three-month moratorium, running from October through December 31, for residents, workers and employers to obtain insurance coverage before enforcement begins.
The governor said every resident, employer and worker in Lagos is expected to obtain coverage through the Lagos State Health Management Agency or an accredited private health insurance provider registered with the state.
“Any law that we cannot enforce, we’re just wasting our time,” Sanwo-Olu said, explaining the decision to provide a grace period before enforcement.
“I’m giving Lagosians a grace period because I truly want compliance. I want people to go out there and have free compliance,” he added.
The governor said the policy was intended not only to expand health insurance coverage but also to change how healthcare was financed in the state by reducing reliance on direct payment by patients when they fall ill.
Lagos made health insurance compulsory through Executive Order EO/BOS/01/2024 signed by Sanwo-Olu in July 2024.
The order requires residents and workers to subscribe to social health insurance through the state scheme or eligible accredited providers.
The state has previously begun enforcement within its own public institutions.
In September, 63 Ministries, Departments and Agencies received certificates of compliance, while MDAs yet to meet the requirements were given until November 30, 2026, to do so.
Under the newly introduced Lagos Private Health Plus partnership, the government said private HMOs would provide an additional route into the mandatory insurance system, particularly for people in the formal sector.
Speaking on the latest development, the Commissioner for Health, Prof. Akin Abayomi, described the enforcement as a policy shift capable of changing the way healthcare was financed and accessed in Lagos.
Abayomi said the heavy dependence on out-of-pocket payments placed financial pressure not only on residents but also on hospitals and the government.
“Insurance is the bedrock of most health schemes in the world. The ability to purchase health must be collective. Health is business, so we must encourage our citizens to purchase health,” he said.
The push comes against a wider problem of heavy out-of-pocket health spending in Nigeria.
The World Health Organisation’s Africa Health Observatory Partnership says out-of-pocket payments account for more than 75 per cent of total health expenditure in Nigeria, exposing households to financial hardship.
The Chairman of the Lagos State Health Management Agency, Adebayo Adedewe, said mandatory insurance was intended to ensure that access to healthcare was not determined by a resident’s income, occupation or social status.
He said the July 2024 executive order had made universal coverage a central instrument of the state’s health policy and pledged that LASHMA would focus on translating the policy into access to healthcare rather than treating enrolment as an end in itself.
“Today’s flag-off signals a transition from sensitisation and institutional preparation to active enforcement of mandatory social health insurance. It is to ensure that residents are covered and that such coverage translates into access to quality healthcare,” Adedewe said.