Health insurance is a crucial structure that ensures individuals’ access to healthcare services and contributes to the sustainability of health systems. However, in some countries, the implementation of this system faces various structural, economic, and social obstacles. The purpose of this study is to examine the structure and development of the health insurance system in Iraq and to evaluate its current status. The research was conducted using a qualitative approach, with data collected through semi-structured interviews with professionals working in the health sector. The collected data were analyzed using content analysis. The findings reveal that the implementation process of health insurance in Iraq faces multidimensional barriers such as institutional disparities, deficiencies in technical infrastructure, and limited public awareness. In particular, the non-digital nature of the system and complex bureaucratic procedures negatively affect participation rates. Furthermore, the lack of public knowledge regarding health insurance contributes to distrust and disengagement from the system. In conclusion, for the effective implementation of the health insurance system, it is essential to strengthen the technical infrastructure alongside the legal framework, increase awareness campaigns targeting citizens, and support the process with digital solutions.