India launches world's largest state-run healthcare programme

Prime Minister Narendra Modi on Sunday launched the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in Ranchi, Jharkhand, describing it as the world's largest government-funded healthcare programme. The scheme aims to provide health protection to more than 50 crore beneficiaries across the country.

Under PMJAY, eligible families will receive health cover of up to Rs 5 lakh per family each year for secondary and tertiary hospitalisation. Beneficiaries will be able to access treatment without making upfront payments at hospitals empanelled under the scheme.

The programme is designed to provide cashless and paperless treatment through a network of public and private healthcare providers. The package covers around 1,350 medical procedures and includes expenses related to hospitalisation, diagnostics, medicines and pre- and post-hospitalisation care.

A key feature of the scheme is its focus on families that are particularly vulnerable to high medical expenses. PMJAY primarily covers poor and deprived rural households and specified occupational groups among urban workers identified through the Socio-Economic Caste Census (SECC). Families covered under the earlier Rashtriya Swasthya Bima Yojana (RSBY) are also included.

The government expects the scheme to reduce the financial burden of hospital treatment on low-income families, many of whom can be pushed into debt by major medical emergencies. By providing access to cashless treatment, the programme is also intended to improve access to quality inpatient care and day-care surgeries.

Ayushman Bharat has two major components. The first involves establishing 1.5 lakh Health and Wellness Centres to provide comprehensive primary healthcare closer to people's homes. The second is PMJAY, which provides financial protection for secondary and tertiary healthcare.

The first Health and Wellness Centre under the programme was inaugurated by Modi at Jangla in Chhattisgarh on April 14.

The scheme also gives states considerable flexibility in deciding how they want to implement it. States can use an existing trust or society, establish a new State Health Agency or adopt another approved institutional structure. They can also implement the programme through an insurance company, directly through a government trust or society, or through a combination of approaches.

At the same time, the Centre has sought to maintain national-level safeguards, including portability of benefits and systems to detect and prevent fraud. Portability is particularly significant for migrant workers and families who may need treatment outside their home state.

Pilot implementation of the scheme had already begun in around 22 states and Union Territories. By the time of the national launch, 30 states and Union Territories had signed memorandums of understanding and begun preparations to implement the mission.

With its large beneficiary base and annual coverage limit of Rs 5 lakh per family, PMJAY represented a major expansion of publicly funded health insurance in India. Its effectiveness, however, would depend heavily on the availability of adequate hospital infrastructure, enrolment of healthcare providers and beneficiaries, and the ability of states to implement the scheme efficiently.