The central government is preparing to double the insurance coverage of beneficiaries of its flagship Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB-PJAY) to Rs 10 lakh per year.
Apart from this, doubling the number of beneficiaries in the next three years is also being seriously considered. The government has also announced to bring all people above 70 years of age under its ambit initially.
Official sources said on Sunday that if the proposals are approved, it will cost the exchequer an additional Rs 12,076 crore per year, as per the National Health Authority’s estimate. Sources said, “There is a discussion on doubling the number of beneficiaries under AB-PMJAY in the next three years, which if implemented will provide health cover to more than two-thirds of the country’s population. Medical expenses are also one of the biggest reasons pushing families into debt.”
“Discussions are also underway to finalise a proposal to double the coverage amount limit from the current Rs 5 lakh to Rs 10 lakh,” he said. These proposals or parts of them are expected to be announced in the Union Budget to be presented later this month.
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Allocation for Ayushman Bharat was increased in the interim budget
In the Interim Budget 2024, the government increased the allocation for ‘AB-PJAY’ to Rs 7,200 crore which provides health cover of Rs five lakh per family per year for secondary and tertiary care hospitalization to 12 crore families. Rs 646 crore was allocated for Ayushman Bharat Health Infrastructure Mission (PM-ABHIM). President Draupadi Murmu said in her address to the joint sitting of Parliament on June 27 that all senior citizens above 70 years of age will now also be covered under the Ayushman Bharat scheme and will get the benefit of free treatment.
At the same time, another source said that the number of beneficiaries of this scheme will increase by about four to five crores by including those above 70 years of age. The limit of Rs 5 lakh for AB-PMJAY was fixed in 2018. The purpose of doubling the cover amount is to provide relief to families in case of high-cost treatment such as organ transplant, cancer etc.
30 percent of the population is deprived of health insurance
Niti Aayog had suggested expanding the scheme in its report titled ‘Health Insurance for India’s Missing Middle’ published in October 2021. It said that about 30 per cent of the population is deprived of health insurance, highlighting the gap in health insurance coverage in the Indian population. About 20 per cent of the population is covered through social health insurance and private voluntary health insurance, which is mainly designed for higher income groups.
The report said that while the remaining 30 per cent of the population is deprived of health insurance, the actual population deprived of health cover is higher due to the existing coverage gaps in PMJAY and the overlap between schemes. This population deprived of health cover is called the ‘missing middle’, the report said.
