The NHI aims to provide universal coverage through a major overhaul of South Africa’s two-tier system. Ramaphosa signed the bill into law just before the May 29 election in which the ANC lost its parliamentary majority.

“We have highlighted the social and economic value of affordable, accessible, quality healthcare available equally to all South Africans,” Ramaphosa said at the closing of an ANC policy meeting on Tuesday.

“We will therefore proceed with the implementation of the National Health Insurance.”

Earlier on Tuesday, health minister Aaron Motsoaledi said the section of the law which outlines transitional mechanisms would be implemented “immediately”. This includes setting up advisory committees and amending other health-related laws to be in line with the NHI.

The legislation will gradually limit the role of private insurance in South Africa, create a new public fund to provide free access for citizens and set the fees and prices private healthcare suppliers can charge for NHI-funded benefits.

Supporters call it a generational change to reverse inequality dating to the apartheid era, but opponents, including big health insurers, say the proposed funding model won’t work.

Motsoaledi said he would listen to concerns from stakeholders and help people understand the NHI.

“The real poor people who are [set to be] beneficiaries haven’t spoken,” he said. “Nobody’s carrying their voice.”

One opponent of the law is the DA, which formerly led the opposition and has now joined the ANC in government. DA leader John Steenhuisen said last month the NHI continued to be a sticking point for the government of national unity and discussions would continue.

Motsoaledi said the bill would be implemented in phases over years and acknowledged legal challenges could delay its rollout.