Ayushman Bharat Health Scheme gets cabinet approval

The world’s largest and India’s most ambitious healthcare program that seeks to provide a health insurance cover of Rs 5 lakh per family per year to 10 crore families received cabinet approval on Wednesday.

The Narendra Modi government had announced the government’s ambitious Ayushman Bharat National Health Protection Mission in Union Budget 2018. Finance Minister Arun jaitley had announced the National Health Protection Scheme, to cover 40% population by bringing 50 crore people under the scheme.

According to a tweet by the government yesterday, the target beneficiaries of the proposed scheme will be more than 10 crore families belonging to ‘poor and vulnerable population’ based on socio-economic caste census database. Interestingly, this is around 40% of the population, as per government estimates.

The mega health insurance scheme aims to raise the mediclaim cover by up to 17 times from the existing Rashtriya Swasthya Bima Yojana (RSBY) that caps it at Rs 30,000 per year. According to the details available currently, Ayushman Bharat will cover all pre-existing diseases and will be portable across all states and union territories in the country.

Accordingly, a beneficiary covered under the NHPs will be eligible for cashless benefits from public or private empanelled hospitals across the country. Further, the 3 days of pre hospitalisation and 15 days of post hospitalisation are also covered under the scheme.

The scheme is proposed a fully government-funded scheme in which the cost will be shared by the centre and states in the ratio of 60:40. The states will be given a choice to adopt insurance company or a trust model as followed under the Central government health insurance scheme.

Currently some states follow their own health insurance schemes. The ambitious project is expected to cost about Rs 10,000-12,000 crore, as per government estimates. Ultimately, all the existing health insurance schemes will be merged with NHPS.

However, there has been some debate regarding the premium payments. As per government’s current estimates, the premium per family could be around Rs 1,000-1,200 a year, about Rs 500 higher than it currently pays for RSBY. Insurance companies have approached the governments saying that they will not be able to bid for the scheme given inadequate premiums, which they expect to be around Rs 2,500. Further, the insurance companies demand that the states will have to pay the premium in advance.

Even though the exact date of rollout of the Ayushman Bharat mission is still unclear, according to reports, the scheme will be effective from October 2018. Sharing the expected timeline, Health Minister JP Nadda said that the mission is likely to be rolled out by year-end.