 "Regional disparities rise as Ayushman cards near quarter-billion mark")
Some places have higher coverage than others under the government’s flagship health scheme run in association with state governments.
Around 242 million cards have been created under Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana (PM-JAY) health coverage scheme. The number of cards created is equivalent to less than a tenth of the state population in some places, while it is over 50 per cent in others.
The scheme was launched in 2018 to cover the bottom 40 per cent of India’s population. The aim was to provide a safety net against rising medical costs especially among the country’s poor and vulnerable population. The government had then estimated such population to be around 120 million families covering 550 million beneficiaries.
About 50 million new cards were created in 2019-20. Issuances of new cards slowed down in the subsequent years. Under 30 million cards were generated in 2020-21 and 2021-22 amid the pandemic. The number of new cards issued has trebled to over 90 million in 2022-23 compared to 2021-22 indicating that more Indians are looking for health coverage than before. Nearly 20 million cards have already been generated since April this year (chart 1).
About 22 states have higher coverage than the all-India average. Over 50 per cent of the population is covered in Dadra and Nagar Haveli and Daman and Diu, Chhattisgarh as well as Jammu and Kashmir. Less than 10 per cent of the population of states like Maharashtra, Bihar, Goa and Tamil Nadu are covered under the Government’s flagship scheme (chart 2).
Some of the differences could be on account of the state’s existing health machinery or priorities. For example, many states like West Bengal, Delhi and Odisha have opted out of the scheme.
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The scheme has largely found greater utility for the older segments of the population. An analysis of the data from the PM-JAY dashboard shows that even though those aged 45 years and above account for just 36 per cent of card issuances, they make up for over 50 per cent of all hospitalisations. Those in the age bracket of 15-44 years account for a more than half of all the new issuances and 43 per cent of all hospital admissions.
Increasing beneficiaries and hospitalisations under the scheme have led to a 12 per cent hike in the budget allocation under the scheme in financial year 2023-24 (FY24). Budget allocation for the scheme was averaging about Rs 6,400 crore since FY20. As per the revised estimates, FY23 will be the first year that the scheme is expected to meet its budget targets after underutilisation in the previous years (chart 3).