The Indian government is taking a significant step towards enhancing the healthcare system by proposing to double the insurance coverage under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) from the existing Rs 5 lakh to Rs 10 lakh per year. This move, aimed at providing better health security, is expected to bring substantial changes to the lives of millions of Indian families.

Expanding the Beneficiary Base

Currently, AB-PMJAY provides health coverage of Rs 5 lakh per family per year, catering to 12 crore families for secondary and tertiary care hospitalization. The central government is now considering doubling the number of beneficiaries over the next three years. If these proposals are approved, it could lead to an additional expenditure of Rs 12,076 crore per year from the government treasury, according to the National Health Authority. This expansion would significantly increase the health cover, benefiting more than two-thirds of the country’s population.

Including Senior Citizens

An important aspect of the proposed expansion is the inclusion of all individuals above 70 years of age under the AB-PMJAY scheme. President Draupadi Murmu, in her address to the joint sitting of Parliament on June 27, announced that all senior citizens above 70 will now be covered under Ayushman Bharat. This inclusion is expected to add about five crore new beneficiaries to the scheme, ensuring that the elderly population receives adequate health coverage.

Addressing Medical Expenses and Financial Burden

One of the primary reasons for this proposed increase in coverage is to provide relief to families facing exorbitant medical expenses, especially in cases requiring organ transplants, cancer treatments, and other critical health conditions. Medical expenses are a significant factor pushing families into debt, and by doubling the coverage amount, the government aims to alleviate this financial burden.

The Need for Expanded Coverage

The AB-PMJAY scheme was initially launched in 2018 with a coverage limit of Rs 5 lakh. However, as medical costs have risen over the years, there has been a growing demand to increase this limit. The NITI Aayog, in its October 2021 report titled ‘Health Insurance for India’s Missing Middle,’ highlighted that approximately 30% of the population remains without health insurance. This segment, referred to as the ‘missing middle,’ includes those who are neither poor enough to be covered under government schemes nor rich enough to afford private insurance. Expanding the AB-PMJAY scheme is expected to bridge this gap and bring more people under the health insurance umbrella.

Increased Budget Allocation

In the Interim Budget 2024, the government has already shown its commitment to enhancing healthcare by increasing the allocation for AB-PMJAY to Rs 7,200 crore. Additionally, Rs 646 crore has been allocated for the Ayushman Bharat Health Infrastructure Mission. These budgetary provisions indicate the government’s focus on strengthening the healthcare infrastructure and ensuring comprehensive health coverage for its citizens.

The proposal to double the insurance coverage under the Ayushman Bharat scheme and expand the beneficiary base is a crucial step towards achieving universal health coverage in India. By addressing the needs of the ‘missing middle’ and including senior citizens, the government aims to provide equitable and accessible healthcare to all. As the Union Budget announcement approaches, there is hope that these proposals will be approved, marking a significant milestone in India’s healthcare journey.