The Pradhan Mantri Jan Arogya Yojana (PM-JAY) has delivered free hospital care valued at INR 90,204 crores to over 68 million beneficiaries since its inception in September 2018, according to recent official data.

PM-JAY is one of the world’s largest government-funded healthcare programs, offering an annual health coverage of INR 5 lakhs to each eligible family. The scheme is designed to cover nearly 2,000 medical procedures, including treatments, medicines, diagnostics, physician fees, and hospital charges, all provided on a cashless basis.

Significant Impact on Healthcare Accessibility

The scheme primarily targets the bottom 40% of India’s population, providing critical financial protection to around 107 million economically disadvantaged households. One of PM-JAY’s most significant impacts has been the reduction in out-of-pocket healthcare expenses, which previously led to severe financial distress and pushed many families into poverty. Before PM-JAY, an estimated 62% of healthcare costs were paid directly by individuals.

Leading States and Common Treatments

Tamil Nadu, Karnataka, Rajasthan, Kerala, Andhra Pradesh, and Gujarat are among the states with the highest number of beneficiaries under the PM-JAY scheme. The most frequently availed treatments include general medicine, infectious diseases, general surgery, medical oncology, ophthalmology, and orthopedics. Procedures such as hemodialysis, COVID-19 screenings, and acute febrile illness treatments are among the most commonly provided services.

To date, over 353.4 million Ayushman Cards have been issued to beneficiaries, facilitating easier access to these benefits. Additionally, the scheme has empaneled 30,357 public and private hospitals, ensuring widespread availability of services across the country.

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Proposal to Extend Coverage to the ‘Missing Middle’

In a recent report, the Parliamentary Standing Committee on Finance recommended extending the PM-JAY scheme to the “missing middle” population on a paid basis. This group, which constitutes about 30% of the population or roughly 400 million individuals, currently lacks financial protection for healthcare, according to a 2021 report by NITI Aayog. Expanding the scheme to include this segment could provide critical support and enhance access to essential healthcare services.

Advances in Healthcare Digitization

In another milestone, the National Health Authority (NHA) recently achieved a significant feat in its healthcare digitization mission by generating 4 crore tokens for outpatient department (OPD) registrations through the ABHA-based Scan and Share service.

PM-JAY continues to play a pivotal role in transforming India’s healthcare landscape by making quality healthcare accessible and affordable to millions, and efforts to expand and digitize the scheme promise even greater impact in the years to come.

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