The National Health Insurance Scheme’s (NHIS) evolving membership figures and the persistent issue of illegal charges at health facilities have returned to public discussion.
The Chief Executive Officer (CEO) of the National Health Insurance Authority (NHIA), Dr. Victor Asare Bampoe, has outlined the scale of progress, the institutional challenges, and the reforms currently pending ministerial and board approval.
His explanations, delivered during a media engagement, formed a chronological account of how the NHIS has expanded, why frustrations persist within the health-care ecosystem, and what structural decisions lie ahead for sustained improvement.
Dr. Bampoe began by situating the national conversation within the recent trajectory of NHIS enrolment. He noted that active cardholders have risen to about 20 million, representing a significant jump over the past year. “Active membership now stands at around 20 million, a clear increase of about 1.5 million compared to 2024,” he said.
He underscored the expansion of the scheme under President John Dramani Mahama’s administration in 2025, explaining that the end-of-year target of 21 million remains attainable if current enrolment and renewals continue to build on the momentum generated by district-level mobilisation and new digital service options.
Dr. Bampoe’s emphasis on usage was equally central to the conversation. He clarified that card ownership and annual utilisation should not be interpreted as identical data sets. “Card ownership reflects preparedness, but utilisation patterns depend on whether a person actually falls sick within the year,” he explained.
“20 million Ghanaians actually have the card. So if they fall ill, they can go and use the card. That’s what it means. I think card ownership is important because they’ve taken the trouble in 2025 to renew.
“Some people use it two times in a year, three times. So I can tell you for a fact that maybe 17 million or 15 million have used it. But then we have to then disaggregate it and say one person has used it four times or one person has used it three times”
Dr. Victor Asare Bampoe, NHIA CEO
The NHIA CEO urged Ghanaians to ensure that their membership remains active, stressing that the first barrier to healthcare access should never be whether a card is valid. This expression of readiness, he noted, is essential for the continued strengthening of the system.
Addressing Illegal Hospital Fees
Dr. Bampoe moved into one of its most persistent controversies of the scheme; “illegal fees charged by some providers.”
He acknowledged that many facilities claim NHIA tariffs do not fully reflect the realities of service delivery. Hospitals that make these claims argue that tariffs have not kept pace with operational costs, especially within higher-volume centres where diagnostic work and general patient load have increased across urban districts.
“We know that providers say the tariffs are not realistic, but illegal fees cannot be justified; they defeat the purpose of the National Health Insurance Scheme.
“I have a three-point vision, and one point is looking at having patients have a beautiful experience when they go to hospitals. In many hospitals, that is not happening now because they are asked to pay out-of-pocket”
Dr. Victor Asare Bampoe, NHIA CEO
Dr. Bampoe insisted that the practice of illegal payments was unacceptable and undermined the core purpose of the scheme. Adding that they breed mistrust and create inequities in access, he stressed that transparent system reforms are the only sustainable alternative.
He further revealed that opportunities for feedback and complaint tracking are being expanded to ensure that citizens have more direct channels for reporting these charges. He warned that paying realistic tariffs by the government must become the baseline expectation and not an optional demand from private or public providers.
“Once tariffs reflect the real cost of care, there will be no legitimate reason for illegal fees,” he explained, drawing focus to reforms already completed on the technical side but awaiting the necessary institutional approvals.
Dr. Bampoe said the NHIA has fully concluded the nationwide review of service tariffs, proposing a significant upward adjustment of 120 percent. He explained that while the medicines tariff review had already been completed, the service tariff revision began in 2022 and has now reached the stage where implementation can begin once authorised by the governing board and the Minister for Health.
“The technical work is done; what is left is board approval and the Ministry’s formal authorisation,” he added, stressing that the proposed increase is meant to eliminate one of the most cited justifications for illegal charges. With the new tariff structure, the NHIA expects that facilities will have the financial clarity they require, aligning service delivery costs with reimbursements.
Dr. Bampoe noted that the process is part of the broader stabilisation programme under the Mahama administration, which has prioritised health financing as a pillar of its 2025 governance reforms. “A 120 percent increase is not cosmetic; it fundamentally changes the financing environment for both providers and patients,” He said, emphasising the transformative potential of the revision.
He concluded by reaffirming that the Authority remains committed to building public confidence through evidence-based reforms, transparent communication, and a long-term approach that ensures both sustainability and fairness.
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