Lagos begins enforcement of mandatory health insurance
….warns residents compliance is ‘not optional’ The Lagos State Government has begun enforcing its Executive Order on Mandatory Social Health Insurance, directing all residents to enrol in the Lagos State
....warns residents compliance is ‘not optional’
The Lagos State Government has begun enforcing its Executive Order on Mandatory Social Health Insurance, directing all residents to enrol in the Lagos State Social Health Insurance Scheme, known as ILERA EKO.
Government officials said enforcement has started across Ministries, Departments and Agencies (MDAs), with expansion to the informal sector expected next.
At a strategic retreat with Local Government and Local Council Development Area (LG/LCDA) chairmen in Lagos, the Chairman of the House Committee on Health, Lawal Musibau, said the legal framework for the scheme had been in place since the Lagos State Health Scheme Law of 2015.
He said the law established the Lagos State Health Management Agency (LASHMA) and the Lagos State Health Fund to ensure sustainable healthcare financing.
Musibau told the council chairmen that enforcement had commenced and warned that awareness alone would not be enough.
“Awareness alone is insufficient; deliberate action and sustained commitment are required to guarantee compliance and affordable healthcare for our people,” he said.
He urged the chairmen to take ownership of the scheme in their councils and sponsor vulnerable residents where possible.
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Also speaking, the Head of Service, Mr. Bode Agoro, described the Executive Order signed on July 16, 2024, as “a bold reform aimed at guaranteeing Universal Health Coverage for all residents of Lagos State.”
Agoro said his office had issued compliance circulars and set up a 26-member Enforcement Team to ensure adherence.
He added that proof of enrolment is now required to access certain government services.
“Compliance is not optional, it is a statutory obligation,” he said.
According to him, enforcement has already begun in some MDAs and full compliance is expected by the second quarter of the year.
The Commissioner for Health, Prof. Akin Abayomi, said the reform was necessary because many Nigerians still pay for healthcare out of pocket.
“In Nigeria today, a significant proportion of healthcare expenses are paid out-of-pocket. This is neither sustainable nor equitable,” he said.
Abayomi explained that mandatory insurance would replace informal, connection-based support with a structured system that is fair and sustainable.
He added that laws without enforcement often fail.
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“The Executive Order strengthens the legal mandate and signals government’s resolve to ensure that every resident carries a health insurance plan, either self-funded or subsidised for the vulnerable,” he said.
Earlier, the Chairman of LASHMA’s Board, Dr. Adebayo Adedewe, said local governments must drive enrolment because they are closest to the people.
“Experience has shown that when Local Governments take ownership, enrolment increases; and when leadership speaks clearly, communities listen,” he said.
The Permanent Secretary of LASHMA, Dr. Emmanuella Zamba, said each council would designate two enforcement officers to work with the state team.
She stressed that enforcement would not be punitive.
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“Enforcement is not punitive but compliance-driven,” she said, adding that weekly review meetings, market associations and local permit structures would be used to expand coverage.
Zamba also called for office space within council premises, stronger mobilisation and support for door-to-door campaigns.
The Permanent Secretary, Ministry of Local Government, Chieftaincy and Rural Development, Mrs. Kikelomo Bolarinwa, said full implementation would reduce the pressure on councils that are often asked to help residents pay hospital bills.
Similarly, the Permanent Secretary, Office of the Auditor General for Local Government, Mr. Obafemi Ogunlana, said access to quality healthcare “is a core dividend of democracy” and should not depend on political affiliation.
All 57 council chairmen were decorated as ILERA EKO Champions at the event. Ten of them were further honoured as EKOSHA Icons for committing resources and support to enrol vulnerable residents.
With enforcement already underway in government agencies and plans to extend it to the informal sector, the state government said it is determined to ensure that every resident is covered and protected from heavy medical bills.
