NHIA recently introduced draft legislation to advance primary care across the country and continue our path toward universal health coverage. As part of the legislative process, we are updating the public on the core pillars of the proposed NHI Bill and how it impacts public and private insurance holders. Your feedback and participation are critical to the success of our mission – it will be noted and considered as we work to finalize the draft bill. For this reason, we have attached an FAQ sheet and a copy of the draft legislation, along with a feedback form to seek your input.
2017, the National Health Insurance Authority (NHIA) was created with the mandate of providing affordable and accessible primary healthcare services to Bahamians. NHIA also represented the first step towards a universal healthcare system, where any citizen or resident would be covered for care, regardless of their income or ability to pay.
As of 2022, NHIA has enrolled over 135,000 Bahamians into the program, many of whom previously did not have access to primary care. We continue to maintain high patient satisfaction rates, with over 90% of Bahamians satisfied with the current benefits provided through the National Health Insurance program.
However, as we continue expanding services and improving the quality of primary care, new legislation is required to address the complexities of the current system and the need to modernize care delivery. This includes the introduction of an Electronic Health Record (EHR) system across all clinics and the restructuring of patient care to assign every patient to a single primary care provider. Other key changes addressed in the draft legislation include:
- Establish a minimum standard of coverage (the Standard Health Benefit) to be provided in all private health insurance plans that will mirror coverage provided by NHIA. All health insurers will be required to provide this minimum standard in all plans provided to residents of The Bahamas unless there is confirmation that coverage was attained elsewhere.
What it means: Everyone will have access to basic primary care, regardless of whether they receive private health insurance coverage or not.
- Expand the national network of providers, both public and private, to deliver Standard Health Benefits. This will establish a national fee schedule for the provision of these services. Note that all providers onboarding to NHI’s network must meet NHIA’s quality standards, including active membership to the Bahamas Medical Council and licensing from the Hospitals and Health Care Facilities Licensing Board.
What it means: Care standards will be implemented to ensure that everyone receives high-quality primary care coverage.
- Modify NHI eligibility such that only individuals without private insurance will be eligible to receive benefits paid for by NHIA. Once enrolled, eligible Bahamians will continue to be registered with NHI and in the event, they lose their private insurance, NHI will begin making payments for Standard Health Benefits services. In this way, NHI becomes the insurer of last resort.
What it means: Individuals with private insurance will continue receiving primary care through their insurer. Those without private health insurance will be covered by NHIA.
- Establish a requirement for private insurers to enter into data-sharing agreements with the NHIA to establish a national database of health insurance holders to better coordinate coverage and identify who is required to provide payment to providers in the Standard Health Benefits Network.
What it means: The insurance status of beneficiaries will be managed between NHIA and private insurers to ensure that anyone who loses private insurance is picked up by NHIA.
Throughout the legislation development process, NHIA has prioritized public and stakeholder consultation to ensure we address the needs of those impacted most by the legislation. Over the past six months, NHIA has engaged various stakeholder groups including the Insurance Commission of The Bahamas, the Bahamas Insurance Association, the Bahamas Chamber of Commerce, and the Medical Association of The Bahamas.
Included below is a survey to gauge feedback about the incoming legislation and NHIA’s progress to date. If you have any other comments or questions, please email us at pctifeedback@nhibahamas.gov.bs or call (242)-396-8500.