The central government is preparing to double the insurance coverage of the beneficiaries of its flagship Ayushman Bharat—Pradhan Mantri Jan Arogya Yojana (AB-PJAY) to Rs 10 lakh per year. In addition, serious consideration is being given to doubling the number of beneficiaries during the next three years. The government has also announced that it will initially bring all people above 70 under its purview.
Official sources said on Sunday that if the proposals are approved, according to the National Health Authority estimate, the government treasury will have to spend an additional Rs 12,076 crore per year. 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 the quagmire of debt.’
He said, ‘Discussions are also going on to finalize the proposal to double the coverage amount limit from the current Rs 5 lakh to Rs 10 lakh.’ These proposals, or parts of them, are expected to be announced in the Union Budget, which will be presented later this month.
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 coverage of Rs 5 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 Droupadi Murmu said in her address to the joint session of Parliament on June 27 that all senior citizens above the age of 70 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, 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 transplants, cancer, etc.
30 Percent Of The Population Deprived Of Health Insurance
NITI Aayog suggested expanding the scheme in its report, ‘Health Insurance for India’s Missing Middle, ‘ published in October 2021. The report said that about 30 percent of the population is deprived of health insurance, highlighting the gap in health insurance coverage in the Indian population. About 20 percent of the population is covered through social and private voluntary health insurance, mainly designed for high-income groups.
The report said that while the remaining 30 percent of the population is deprived of health insurance, the actual population deprived of health coverage is higher due to the existing coverage gaps in PMJAY and the overlap between schemes. This population deprived of health coverage is called the ‘missing middle’.
