With the Union Cabinet expanding the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) to provide health coverage to people aged 70 years and above, regardless of their income level, public healthcare, as we know it, is expected to undergo a sea change. It also eases the anxieties of India’s rapidly growing ageing citizens, who find it difficult to manage their disease burden given the high cost of medical care, drugs and therapies without a social security net.
Currently, the scheme is income-based and provides Rs 5 lakh shared annual coverage to all members of eligible families estimated to comprise the bottom 40 per cent of the population economically irrespective of their age. With the Cabinet clearing the extension of the scheme, Rs 5 lakh annual coverage per family will be provided to all citizens aged 70 years and above. An additional 6 crore people in this age group, from 4.5 crore families, are expected to benefit, according to a government statement. The eligible beneficiaries will be issued a new card under PM-JAY.
CAN ALL 70-YEAR-OLDS BENEFIT FROM THIS SCHEME?
The government says that senior citizens aged 70 and above, and belonging to families already covered under AB PM-JAY, will get an additional (shared) top-up cover up to Rs 5 lakh per year for themselves.
Those already availing benefits of other public health insurance schemes such as Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), Ayushman Central Armed Police Force (CAPF) may either continue their existing scheme or opt for AB PM-JAY.
Senior citizens of 70 years and above, who are under private health insurance policies or Employees’ State Insurance Scheme, will be eligible to avail benefits.
DOES THE SCHEME COVER EVERY SENIOR CITIZEN IN A FAMILY?
As Union Information and Broadcasting Minister Ashwini Vaishnaw explained, the health coverage in such a scenario will be shared by the eligible beneficiaries of a family. “If there are two senior citizens (70 years+) in a family, then the Rs 5 lakh coverage will be shared between them. This is a big step towards ensuring the social security of senior citizens, especially as India transitions to nuclear families,” he said.
WHY IS THIS SCHEME SIGNIFICANT?
While the Ayushman Bharat scheme was geared towards universal health coverage, this will be the first age cohort to receive complete coverage.
WHAT WILL IT COST THE GOVT TO ROLL OUT THIS HEALTH SHIELD?
The initial outlay of the scheme will be Rs 3,437 crore. “This is a demand based scheme; as the demand goes up, the coverage will also be increased,” said Vaishnaw.
Sources said while most states will foot 40 per cent of the bill, 90 per cent of the cost is likely to be borne by the Centre for states in hilly regions and the Northeast. “The nitty-gritty will be worked out later. It will happen at the stage of implementation, once the decision has been taken,” said a senior official.
Experts have estimated the cost of expanding the coverage to all persons over 70 years would be higher than that for covering the poorest 40 per cent across all age groups.
WILL THE HEALTH COVER MINIMISE THE DISEASE BURDEN?
India’s population over the age of 60 years is estimated to increase from 8.6 per cent in 2011 to 19.5 per cent by 2050, according to the Longitudinal Ageing Study in India (LASI). In terms of absolute numbers it means that the 60 plus population is set to triple from 103 million in 2011 to 319 million in 2050. Health coverage in this age group is currently about 20 per cent, according to the India Ageing Report 2023.
