As India ages, BJP manifesto vows PMJAY cover for all citizens above 70 yrs

Experts feel the idea is to cover the middle-tier of the population with healthcare coverage

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY), the flagship health care insurance scheme of the Bharatiya Janata Party-led central government, launched in September 2018, is likely an expansion in scope, covering all citizens above the age of 70 and the transgender community if the Bharatiya Janata Party (BJP) returns to power this year.

Releasing the party manifesto for the 2024 Lok Sabha elections on Sunday, Prime Minister Narendra Modi said the BJP was “determined to encompass every senior citizen above 70 years of age under the Ayushman Bharat Scheme”.

Till now, the PMJAY has covered over 341 million citizens who received free health insurance of Rs 5 lakh for hospitalisation.

The manifesto read: “We have provided quality free health treatment of up to Rs 5 lakh to poor families under Ayushman Bharat. We will continue to provide free health treatment by strengthening Ayushman Bharat and other such initiatives.”

The data from the National Health Authority dashboard shows that cumulatively the scheme has covered 65 million cases of hospitalisation, entailing Rs 81,979 crore since its inception.

In the past one month alone, 1.7 million people were hospitalised under the scheme, entailing Rs 2,314.7 crore.

General medicine, infectious diseases, and general surgery are the three main therapy areas covered by the Ayushman Bharat scheme now, while haemodialysis is the top-most procedure the scheme covers (see charts).

The scheme is aimed at reducing out-of-pocket expenditure (OOPE) for the poor, and Modi said this scheme had been adopted even in Opposition-ruled states.

Out-of-pocket expenditure (OOPE) for health care services is projected to fall to 35 per cent by 2025-26 from 44 per cent recorded in the National Health Accounts of 2021, the Union health ministry had said in November.

This fall in OOPE can be attributed to an increase in the share of government health expenditure from 45 per cent in 2021 to a projected 55 per cent by 2025-26.

Watch: BJP Manifesto, key promises and initiatives

If voted back to power, the BJP is thus banking on this flagship scheme and promising to expand its coverage further.

“We will expand the Ayushman Bharat Yojana to cover Senior Citizens and provide them access to free and quality healthcare…We will expand the network of Garima Grahas to cater to the needs of transgender individuals. We will issue identity cards to ensure their recognition nationwide. Furthermore, all eligible transgender individuals will be covered under the Ayushman Bharat Yojana,” the manifesto said.

The focus on senior citizens is understandable because the recent data shows the relatively young India today will turn into a rapidly ageing society in the coming decades.

According to the “India Ageing Report 2023”, by the United Nations Population Fund, in collaboration with the International Institute for Population Sciences, by 2050 one-fifth of India’s population will comprise people above 60.

The figure was 10.5 per cent in 2022.

The percentage of the elderly increased swiftly in recent years, and the trend is likely to continue in the coming decades. By the end of the century, the elderly will constitute over 36 per cent of the population of the country.

Probal Ghosal, chairman and director, Ujala Cygnus, which runs a network of 21 hospitals in five states, said through the promises made in this latest manifesto, the idea was to address the middle tier of the population, which was left uncovered in health care insurance or had limited access to healthcare facilities.

Industry sources said the Centre was working on increasing coverage under Ayushman Bharat to Rs 10 lakh.

Speaking to Business Standard, public health policy expert Dilip Mavlankar said there was a need to move towards universal health care, and also improve the public health infrastructure and quality at the same time.

The manifesto also noted the upgrading of secondary and primary health care under PM-ABHIM (PM-Ayushman Bharat Health Infrastructure Mission).