Universal Health Coverage (UHC) means that all people can access the quality health services they need without suffering financial hardship paying for them -- it is not a specific insurance model, but a goal that can be pursued through different financing mixes of taxation, insurance, and targeted subsidies. In many low- and middle-income countries, out-of-pocket payment at the point of care remains the largest single source of health financing, and when a household must pay a large share of its income for care, this is termed 'catastrophic health expenditure,' a major driver of medical poverty. Nigeria restructured its health insurance architecture in 2022, replacing the National Health Insurance Scheme (NHIS) with the National Health Insurance Authority (NHIA) under a new Act, with a mandate to make health insurance coverage compulsory for all residents rather than largely limited to formal-sector employees as under the previous scheme. Expanding coverage in practice requires more than passing a law: it depends on enrolling the large informal-sector workforce typical of many African economies, which is a harder administrative and financing challenge than covering salaried employees through payroll deductions.