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New Delhi: The government aims to cover all targeted beneficiaries of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) by 26 January as Lok Sabha election nears, a tall task given that it involves bringing 270 million more people into the fold of its flagship health scheme.

The plan is part of fresh directions issued to all central ministries and agencies running various welfare schemes to accelerate the “saturation” of beneficiaries, meaning, covering all intended individuals.

More than 280 million individuals have an Ayushman card, which entitles the holder — someone below the poverty line—accessible quality healthcare. The government’s target is to cover at least 550 million individuals, leaving a massive gap of at least 270 million to be closed in just over a month.

“For us, it is an opportunity to achieve saturation within the set deadline rather than pre-election agenda. Multiple communication is being sent almost every day to the states/UTs. They have been asked to devise daily targets for Ayushman card creation and strive to achieve the same by deploying all resources,” said an official aware of the matter, requesting anonymity.

 According to the official, more than 100 million families have at least one Ayushman card—every individual in a beneficiary family is entitled to one. On top is Uttar Pradesh with 46 million individuals with Ayushman cards, followed by Madhya Pradesh (37 million), Gujarat and Chhattisgarh with 20 million each and Maharashtra (19 million).

“The impact of the increased number of Ayushman cards has resulted in a substantial increase in hospitalization. Now, it is touching 3.16% hospitalization per 100,000 beneficiaries for this financial year which is higher than the national average of 2.9% as per the National Statistical Office,” said the official.

Queries sent to the health ministry and a BJP spokesperson remained unanswered till press time.

The government has spent almost 4,200 crore this year on implementing the scheme.

One way to scale up would be to target what is called the “missing middle”—those who hover just above the poverty line and therefore do not qualify for benefits, but are still too poor to afford private healthcare.

This is a common problem with welfare schemes around the world, and identifying the missing middle is hard to do.

Still, the scheme’s expansion is now due and there are chances the ruling BJP might include missing middle of the PM-JAY in its election manifesto.

About 400 million such individuals (30% of India’s population) are out of the ambit of any health protection scheme, as per a Niti Aayog report, published in October 2021.

Prof. Sri Nath Reddy, former president of Public Health Foundation of India, said, “We need to ensure that no Indian is deprived of essential health services because of an affordability barrier. PMJAY covers 40% of the population. The ‘missing middle’, who can also suffer financial hardship from catastrophic healthcare expenditure, needs to be speedily covered next to make universal health care more of a reality.”

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Published: 20 Dec 2023, 11:37 PM IST

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