Introduction Rwanda healthcare insurance coverage aims to help Rwandans with access to healthcare. However, some individuals face difficulties with obtaining healthcare insurance. This paper provides a critical analysis of policy factors hindering the attainment of total coverage.

Methods A critical policy analysis framework devised from discourse theories by Taylor informed this paper.

Results This paper illustrates the context and antecedents associated with the issue of uninsured individuals. The paper highlighted competing factors and discourses contributing to persistent gap in healthcare insurance coverage in Rwanda. An example of factors is a limited income of individuals assigned to the second Ubudehe category.

It further identifies the nature of the issue and corresponding economic and social consequences, along with priority action steps required to attain total healthcare coverage.

Conclusion To address the issue of uninsured individuals, the Government of Rwanda should target segments of population with the lowest rates of coverage, regardless of their income.