Tanzania enacts landmark Universal Health Insurance Act mandating health insurance coverage for all residents to close the coverage gap, with employers financing the costs of coverage for their workers.

Employer Action Code: Act

The landmark Universal Health Insurance Act of 2023 (UHA) was recently signed into law, mandating that all residents have at least a minimum level of health insurance coverage. Only about 15% of Tanzanians had some form of health insurance at the end of 2021, 8% of whom were covered under the National Health Insurance Fund (Ministry of Health data). Health insurance accounts for about 12% of total spending on healthcare, while out-of-pocket, government and donor spending account for 34%, 24% and 32%, respectively. The UHA will take effect on a date to be announced by the government, followed by a transition period of up to 18 months.

Key details

  • All residents will be mandated to have at least a minimum level of health insurance coverage, from the National Health Insurance Fund or from other approved providers.
  • All employers will be required to ensure that their employees have health insurance coverage. Employers must finance the costs of the coverage chosen by their employees; private-sector employers may instead provide private health insurance for their employees.
  • A fund will be established to meet the cost of health insurance for individuals who are unable to pay. Financing sources are expected to include income from electronic transactions and taxes on carbonated beverages, alcoholic beverages, cosmetic products and gaming (details to be announced).
  • All foreigners age 18 or older staying in the country for more than 30 days must have health insurance coverage.

Employer implications

Most companies operating in emerging markets offer some form of private medical insurance (PMI) or medical services, due to a combination of the limitations of the public healthcare system and employers wanting to ensure that their staff (and usually dependent family members) have prompt access to medical care. The option to offer PMI in lieu of the state-mandated scheme is thus welcome. Employers that do not already provide private health insurance for their employees should prepare to meet the cost resulting from this new mandate.

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