‘Unjustifiable’: Why SA unions are fighting the 2026 GEMS medical aid hikes

Public service unions have announced a national programme of action against the Government Employees Medical Scheme (GEMS) over contribution increases that will leave members 23.2% worse off over two years.

The matter came to the fore some months ago which led GEMS to announce that its proposed 9.8% increase had been revised downwards to 9.5% after concerns were raised by several unions late last year. But the unions had also rejected the 9.5% hike as still being exorbitant.

In a statement after a media briefing at the Public Service Coordinating Bargaining Council (PSCBC) in Centurion on Sunday, organised labour said: “Cumulatively, the increase amounts to a 23.2% over two years,” COSATU-affiliated unions said, describing themselves as “united and outraged” by the decision.

The unions argue that the sharp rise in medical aid contributions comes at a time when public servants are receiving far smaller salary adjustments.

“Public servants received only a 5.5% salary increase in 2025/26, and in 2026/27, the increase might even be below 5%,” they said, adding that government subsidy increases amount to 4.5% from January to March 2026 and only 0.5% from April.

Labour also questioned why GEMS proceeded with the increase despite guidance from the Council for Medical Schemes (CMS).

“It is puzzling that GEMS went ahead to increase the member contribution despite the advice by the Council for Medical Schemes (CMS) on a proposed average member contribution increase of 3.3% for 2026 as reasonable,” unions said. The PSCBC added that the 9.8% increase “significantly exceeds the regulator’s benchmark.”

Lower-income members were singled out as particularly vulnerable.

The PSCBC said there had been “no meaningful restructuring of benefit options to strengthen affordability for lower-income public servants.”

COSATU unions further alleged that “Tanzanite members [are] being excluded from private healthcare despite paying contributions.”

Labour leaders framed the row as a test of collective bargaining in the public service. “The unilateral implementation of the increase undermines the Public Service Coordinating Bargaining Council (PSCBC) and weakens collective bargaining,” they said. “Our fight is not only about medical aid increases, it is about defending collective bargaining and protecting workers’ rights.”

After what they described as fruitless engagements with GEMS leadership, unions announced a two-pronged protest plan.

“Since all the engagements with GEMS failed to yield positive results, we have decided to act by mobilising members across the public service,” they said.

Lunch-hour demonstrations are scheduled for 24 February 2026 at GEMS offices across provinces, followed by a National Day of Action at the scheme’s head office in Pretoria on 26 February 2026.

Among their demands are the “immediate withdrawal of the 9.8%, a full forensic audit into governance, finances and procurement, a review of outsourcing contracts and executive pay, and the removal of the Principal Officer and implicated executives.”

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