The federal government is actively contemplating doubling the beneficiary base below its flagship Ayushman Bharat medical health insurance scheme over the subsequent three years, with all these aged above 70 years to be introduced below its ambit to start with, and likewise improve the insurance coverage protection to Rs 10 lakh per 12 months.
The proposals, if given a go forward, would entail a further expenditure of Rs 12,076 crore every year for the exchequer as per estimates ready by the Nationwide Well being Authority, official sources informed PTI.
“Discussions are taking place to double the beneficiary base below the AB-PMJAY over the subsequent three years, which, if applied, will cowl greater than two-third inhabitants of the nation with well being cowl, the sources mentioned whereas noting that medical expenditure is among the greatest causes that push households to indebtedness.
“Deliberations are additionally underway over finalising a proposal to double the restrict of the protection quantity from the present Rs 5 lakh to Rs 10 lakh,” they mentioned.
These proposals or some elements of it are anticipated to be introduced within the Union Finances to be offered later this month.
Within the interim Finances 2024, the federal government elevated the allocation for the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), which offers well being cowl of Rs 5 lakh per household per 12 months for secondary and tertiary care hospitalization to 12 crore households, to Rs 7,200 crore whereas Rs 646 crore was assigned for the Ayushman Bharat Well being Infrastructure Mission (PM-ABHIM).
President Droupadi Murmu, in her tackle to the joint sitting of Parliament on June 27, had mentioned all of the aged above 70 years of age can even be coated and get the advantage of free remedy below the Ayushman Bharat Yojana now.
These above 70 years of age add as much as round 4-5 crore extra beneficiaries being coated below the scheme, one other supply mentioned.
The restrict of Rs 5 lakh for AB-PMJAY was mounted in 2018. Doubling the duvet quantity is aimed to cater for inflation and supply reduction to households in case of high-cost remedies equivalent to transplants, most cancers and so on.
The NITI Aayog, in its report titled ‘Well being Insurance coverage for India’s Lacking Center’ printed in October 2021, instructed extending the scheme. It had said that about 30 % of the inhabitants is devoid of medical health insurance, highlighting the gaps within the medical health insurance protection throughout the Indian inhabitants.
The AB-PMJAY flagship scheme in the direction of Common Well being Protection, and state authorities extension schemes ?offers complete hospitalisation cowl to the underside 50 per cent of the inhabitants.
Round 20 per cent of the inhabitants is roofed by means of social medical health insurance, and personal voluntary medical health insurance primarily designed for high-income teams.
The remaining 30 per cent of the inhabitants is devoid of medical health insurance, the precise uncovered inhabitants is greater as a consequence of present protection gaps in PMJAY and overlap between schemes. This uncovered inhabitants is termed because the lacking center, the report said.
The lacking center will not be a monolith -? it incorporates a number of teams throughout all expenditure quintiles. The lacking center predominantly constitutes the self-employed (agriculture and non-agriculture) casual sector in rural areas, and a broad array of occupations — casual, semi-formal, and formal — in city areas, the report mentioned.
The report highlighted the necessity for designing a low-cost complete medical health insurance product for the lacking center.
It primarily recognises the coverage problem of low monetary safety for well being for the lacking center phase and highlights medical health insurance as a possible pathway in addressing that.
