As the Universal Health Insurance Plan (RAMU) is being implemented in Mali, community-based health insurance (CBHI) — one of the pillars— must innovate to meet the challenge of universal health coverage. An experimental CBHI was tested in central Mali between 2017 and 2021. This innovative CBHI professionalizes and organizes risk sharing on a larger scale, moving from municipalities to circles (department). A mixed-method study was carried out to assess the acceptability of this innovation among elected representatives of CBHI offices. In April 2021, 118 questionnaires were administered, followed by 43 qualitative interviews from the same sample in October 2021. Sekhon el al. (2017) seven dimensions of acceptability was used as the conceptual model. More than half of individuals (58%) reported above-average acceptability. Elected officials feel well supported in their activities by the Technical Union of Malian Mutuality (UTM), the umbrella organization of CBHI. They show some confidence in their ability to perform their duties effectively despite varying levels of commitment that often fall short of expectations and needs, which they justify by their volunteer status. Elected officials note that the system is very effective despite the nonoptimal conditions linked to the prevailing insecurity. Professionalization appears to be an unavoidable condition for the performance of the innovation, as well as the new community assembly. However, elected officials are concerned about the sustainability. The UTM will play an important role in continuing its support and fulfilling its functions as a delegated management organization within the framework of the RAMU.