Kerala, Tamil Nadu see fewer hospital admissions under Ayushman Bharat

The lesser numbers in Telangana are due to the presence of the state's own health insurance scheme for the poor, 'Aarogyasri,' which later merged with AB-PMJAY only in 2021

Kerala and Tamil Nadu have witnessed a drop in authorised hospital admissions under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in the last three financial years, even as other southern states saw a gradual growth in hospitalisations under the scheme, according to data presented by the Ministry of Health and Family Welfare in the parliament.

According to data accessed by Business Standard, authorised hospital admissions under the scheme in Kerala have dropped from 1.69 million in financial year (FY) 2022 to 1.07 million in FY24. Similarly, the data suggests that the number of PMJAY admissions in Tamil Nadu hospitals have come down from 4.39 million in FY22 to 1.05 million in FY24.

The numbers in Kerala and Tamil Nadu are a stark contrast compared to other southern states. Authorised hospital admissions under the scheme has seen gradual increase in Andhra Pradesh (from 1.13 million in FY22 to 1.84 million in FY24), Karnataka (from 1.08 million in FY22 to 3.21 million in FY24) and Telangana (from 323,421 in FY22 to 618,497 in FY24).

The lesser numbers in Telangana are due to the presence of the state’s own health insurance scheme for poor- ‘Aarogyasri’, which was merged with AB-PMJAY in 2021. Queries mailed by Business Standard to the health ministry remained unanswered till the time of going to press.

A similar trend was seen in the population coverage by southern states, in terms of creating Ayushman Bharat Health Account (ABHA) IDs. The ABHA number is a unique 14-digit identification number under which an individual’s medical history, consultation details, prescriptions etc are registered, creating a unique health database.

According to data posted on the Ayushman Bharat Digital Mission (ABDM) dashboard, Tamil Nadu and Kerala had covered only 16.7 and 49.6 per cent of their populations respectively with ABHA IDs, as compared to Andhra Pradesh and Telangana with 78.4 per cent and 53.7 per cent population coverage respectively.

The ABHA ID is different in coverage, as it is open to all citizens, whereas AB-PMJAY only covers the healthcare costs of the poor who are eligible under the scheme.

The AB-PMJAY is the world’s largest publicly funded health assurance scheme, which aims to provide health cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation to around 550 million (55 crore) individuals, corresponding to 123.4 million families.

The scheme has been rolled out for the bottom 40 per cent of poor and vulnerable citizens, which comes to around 120 million households.

Whether households are included or not depends on the deprivation and occupational criteria of the Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas, respectively. This number also includes families that were covered in the Rashtriya Swasthya Bima Yojana (RSBY) for unrecognised sector workers belonging to below the poverty line (BPL) category, but were not present in the SECC 2011 database.

According to data available on the National Health Authority (NHA) dashboard, the scheme has, so far, covered over 350 million citizens, who have received Ayushman Cards to avail free health insurance of Rs 5 lakh for hospitalisation.