Why Rashtriya Swasthya Bima Yojana has failed India's poor

India's health-related out-of-pocket expenditure, which pushes families into indebtedness and deeper poverty, is among the world's highest

India’s nine-year-old government health insurance programme, the world’s largest, has not eased the burden of healthcare costs borne by its poorest families, a new study has found.

The Rashtriya Swasthya Bima Yojana (RSBY) offers medical insurance up to Rs 30,000 for a family of five living below the poverty line (BPL)–defined as the ability to spend Rs 33 per day in urban India and Rs 27 per day in rural. It is, however, limited to inpatient treatment or hospitalisation.

The programme has not led to any reduction in out-of-pocket expenditure–personal spending–by its 150 million beneficiaries,