
The Indian government is ambitiously aiming to integrate an additional 270 million people into the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) by 26 January, an endeavour coinciding with the approaching Lok Sabha elections. This initiative is part of a broader directive to various ministries and agencies to expedite the inclusion of all intended beneficiaries in numerous welfare programmes, striving for complete coverage.
Currently, over 280 million individuals possess an Ayushman card, providing access to quality healthcare for those below the poverty line. The government’s objective is to extend this coverage to at least 550 million people, leaving a significant gap of approximately 270 million individuals to be addressed in a little over a month.
A government official, speaking under the condition of anonymity, highlighted the approach of treating this as an opportunity to meet the deadline rather than a pre-election strategy. There’s a continuous push, with daily communications to states and union territories, setting daily targets for Ayushman card issuance and utilising all available resources to meet these goals.
More than 100 million families currently have at least one member holding an Ayushman card. Uttar Pradesh leads with 46 million cardholders, followed by Madhya Pradesh with 37 million, Gujarat and Chhattisgarh with 20 million each, and Maharashtra with 19 million.
The increase in Ayushman cardholders has notably led to a rise in hospitalisations, now at 3.16% per 100,000 beneficiaries for the current financial year, surpassing the national average of 2.9% according to the National Statistical Office.
Despite efforts to contact the health ministry and a BJP spokesperson, there has been no response as of press time. This year, nearly ₹4,200 crore has been allocated towards implementing the scheme.
A potential strategy for expansion is to focus on the ‘missing middle’—individuals slightly above the poverty line who are ineligible for benefits but cannot afford private healthcare. This group often presents a challenge in welfare schemes globally due to the difficulty in accurately identifying them. The ruling BJP is considering incorporating this segment into the PM-JAY in its election manifesto.
According to a Niti Aayog report from October 2021, about 400 million people (30% of India’s population) are currently not covered by any health protection scheme. Prof. Sri Nath Reddy, former president of the Public Health Foundation of India, emphasised the importance of ensuring that no Indian faces the inability to afford essential health services. With PMJAY covering 40% of the population, swiftly including the ‘missing middle’ is a crucial step towards achieving universal healthcare in India.
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