Ayushman Bharat Expansion: Insurance Cover Doubled, Focus on Women’s Health, and 4 Lakh New Hospital Beds Planned

(Source: Indian Express; Section: Cover Page; Page: 01)

Topic: GS2 – Social Justice – Health

Context:

The Union Health Ministry plans to double the insurance cover under Ayushman Bharat from Rs 5 lakh to Rs 10 lakh per family, with an additional increase to Rs 15 lakh for women in specific cases. This expansion is part of the government’s broader goal to increase the number of beneficiaries from 55 crore to 100 crore, aiming to significantly enhance healthcare access for India’s population.

 Analysis of News:  

What is Ayushman Bharat-PMJAY?

• PM-JAY is the world’s largest health insurance scheme fully financed by the government.
• Launched in 2018, it offers a sum insured of Rs.5 lakh per family for secondary care and tertiary care.
• Health Benefit Packages covers surgery, medical and day care treatments, cost of medicines and diagnostics.

Beneficiaries:

• It is an entitlement-based scheme that targets the beneficiaries as identified by latest Socio-Economic Caste Census (SECC) data.
• The National Health Authority (NHA) has provided flexibility to States/UTs to use non- Socio-Economic Caste Census (SECC) beneficiary family databases with similar socio-economic profiles for tagging against the leftover (unauthenticated) SECC families.

Funding:

• The funding for the scheme is shared – 60:40 for all states and UTs with their own legislature, 90:10 in Northeast states and Jammu and Kashmir, Himachal and Uttarakhand and 100% Central funding for UTs without legislature.

Nodal Agency:

• The National Health Authority (NHA) has been constituted as an autonomous entity under the Society Registration Act, 1860 for effective implementation of PM-JAY in alliance with state governments.
• The State Health Agency (SHA) is the apex body of the State Government responsible for the implementation of AB PM-JAY in the State.

 Increasing Hospital Bed Capacity

• To accommodate the increased coverage, the Ministry also plans to add 4 lakh private hospital beds under the Ayushman Bharat scheme.
• The current 7.22 lakh private hospital beds are expected to rise to 11.12 lakh by 2028-29, addressing the growing demand for healthcare services.

Focus on Women’s Health

• The initiative highlights a specific focus on women, with plans to extend higher insurance coverage for women under certain conditions. This aims to address gender disparities in healthcare access and outcomes.

Enhancing Jan Aushadhi Kendras

• In addition to expanding insurance coverage and hospital bed capacity, the Ministry plans to increase the number of Jan Aushadhi Kendras from 10,000 to 25,000.
• These centers provide affordable medicines, further supporting the goal of making healthcare more accessible and cost-effective.

Strategic Goals and Timelines

• These initiatives align with the NDA government’s broader goals for its third term, as outlined by the Group of Secretaries on the social sector.
• The proposals will be formalized and presented for approval after considering recommendations from the NITI Aayog.

Practice Question:  Evaluate the potential impact of doubling the insurance coverage under Ayushman Bharat and expanding hospital infrastructure on India’s healthcare accessibility. How might these changes address gender disparities and the healthcare needs of a growing population? (250 words/15 m)