Govt to Merge ESIC with Ayushman Bharat for Expanded Healthcare Access

Post-integration, ESIC will gain access to a network of approximately 24,000 hospitals empaneled under Ayushman Bharat, offering up to INR 5 lakh annually for hospitalization expenses to eligible households.

The government is set to integrate healthcare services provided by the Employees’ State Insurance Corporation (ESIC) with the Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY), a cashless hospitalization scheme.

Established under the Employees’ State Insurance Act of 1948, ESIC covers workers earning up to INR 21,000 per month and currently supports 30.72 million beneficiaries.

Post-integration, ESIC will gain access to a network of approximately 24,000 hospitals empaneled under Ayushman Bharat, offering up to INR 5 lakh annually for hospitalization expenses to eligible households. ESIC will continue to fund hospital bills as before.

Integrating with AB-PMJAY is expected to enhance workers' healthcare capacity nationwide significantly.

Currently, ESIC operates 165 hospitals, including medical colleges, and 1,574 dispensaries nationwide. However, these facilities are insufficient to meet the needs of workers in all districts.

Further, despite an upward trend, public health spending remains below the national target of 2.5% of GDP, standing at approximately 1.9%, as per the Economy Survey 2024-25.

G Sanjeeva Reddy, a leader of the Indian National Trade Union Congress, highlighted ongoing challenges, including incomplete district coverage, quality issues in healthcare services, long queues, and a shortage of dispensaries. He reiterated the demand for a full-fledged hospital in every district.

ESIC, a social security organization, is vital in delivering healthcare to the most vulnerable among organized-sector workers. Its services include unlimited hospital admissions, outpatient care, sickness allowances, and maternity benefits.

As part of its expansion, ESIC recently extended its coverage to 15 more districts, bringing the total to 689 districts, of which 586 are fully covered, according to labor minister Mansukh Mandaviya.

Additionally, plans are underway to establish 20 new medical colleges with “in-principle” approval for 10 new medical colleges in cities such as Mumbai, Delhi, Guwahati, Indore, Jaipur, Ludhiana, Naroda-Bapunagar in Gujarat, Noida, Varanasi, and Ranchi. Plans for the other 10 colleges are also in progress.

Last year, the Ministry of Health and Family Welfare introduced significant measures, including extending Ayushman Bharat coverage to citizens aged 70 and above and launching the U-WIN portal to digitize vaccinations for pregnant women and children.

Further, the Union Minister of State for Health, Prataprao Jadhav, informed that over 73.98 crore Ayushman Bharat Health Accounts (ABHA) have been created, with more than 49.06 crore health records successfully linked to these accounts.

This reflects the government's continued push towards digitizing healthcare under the Ayushman Bharat Digital Mission (ABDM).

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