Written by : Jayati Dubey
December 21, 2023
Uttar Pradesh leads the states with 46 million individuals holding Ayushman cards, followed by Madhya Pradesh (37 million), Gujarat and Chhattisgarh with 20 million each, and Maharashtra (19 million).
As the Lok Sabha election approaches, the Indian government is on a mission to achieve comprehensive coverage under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) by January 26. This ambitious endeavour involves incorporating an additional 270 million individuals into the ambit of the flagship health scheme.
Recent directives have been issued to all central ministries and agencies overseeing various welfare schemes to expedite the "saturation" of beneficiaries, signifying the comprehensive coverage of all intended individuals.
Currently, over 280 million individuals possess an Ayushman card, granting holders, particularly those below the poverty line, access to quality healthcare. The government aims to extend this privilege to at least 550 million individuals, leaving a substantial gap of 270 million to be bridged in just over a month.
Speaking anonymously, an official familiar with the matter said, "For us, it is an opportunity to achieve saturation within the set deadline rather than a pre-election agenda. Multiple communications are being sent almost every day to the states/UTs. They have been asked to devise daily targets for Ayushman card creation and strive to achieve the same by deploying all resources."
More than 100 million families currently possess at least one Ayushman card, with every individual in a beneficiary family entitled to one. Uttar Pradesh leads the states with 46 million individuals holding Ayushman cards, followed by Madhya Pradesh (37 million), Gujarat and Chhattisgarh with 20 million each, and Maharashtra (19 million).
The surge in Ayushman card issuance has correlated with a significant increase in hospitalisation. According to the National Statistical Office, the hospitalisation rate is now at 3.16% per 100,000 beneficiaries for this financial year, surpassing the national average of 2.9%.
The government has allocated nearly INR 4,200 Cr this year to implement the AB PM-JAY scheme. To scale up further, one strategy could involve targeting the "missing middle"—those hovering just above the poverty line and ineligible for benefits but still unable to afford private healthcare. Identifying this segment is challenging, yet addressing it is essential for inclusive healthcare.
Approximately 400 million individuals, constituting 30% of India's population, are currently outside the purview of any health protection scheme, as highlighted in a Niti Aayog report from October 2021.
Professor Sri Nath Reddy, former president of the Public Health Foundation of India, emphasised the need to swiftly cover the "missing middle" to make universal healthcare more of a reality, saying, "We need to ensure that no Indian is deprived of essential health services because of an affordability barrier. PMJAY covers 40% of the population. The 'missing middle,' who can also suffer financial hardship from catastrophic healthcare expenditure, needs to be speedily covered next to make universal health care more of a reality."
As the scheme continues to evolve, its impact on hospitalisation rates and financial allocation showcases a concerted effort to make universal healthcare a reality for a significant proportion of the population. With challenges ahead, the coming months will be crucial in determining the success of this pivotal healthcare initiative.