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Rachel V Thomas

India's Parliamentary Panel Calls For Doubling Ayushman Bharat Cover To Rs 10 Lakh

India's flagship <span>health insurance scheme</span>, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), which covers more than 62 crore people, could soon offer higher financial protection if a key parliamentary recommendation is accepted.

A <span>Parliamentary Standing Committee</span> on Health and Family Welfare has recommended increasing the insurance cover under PM-JAY from the current Rs 5 lakh to Rs 10 lakh, according to a report by The Times of India.

The committee said the existing coverage is inadequate to meet the cost of several life-saving treatments, including liver transplants, complex cardiac surgeries, and immunotherapy.

<ul><li>Increasing PM-JAY health insurance coverage from ₹5 lakh to ₹10 lakh.</li><li>Introducing special high-cost treatment packages for expensive procedures.</li><li>Adopting a differential pricing model for complex and advanced medical interventions.</li>Supporting higher coverage through:</ul>

<ul><li>Pooled financing</li><li>Negotiated pricing with hospitals and medical device manufacturers</li><li>Co-funding mechanisms with states.</li></ul>

<h2>Recommendations To Improve <span rel="noindex">Cashless Treatment</span></h2>

To improve the efficiency of the scheme, the committee also recommended:

<ul><li>Strict enforcement of the six-hour turnaround time for pre-authorization of cashless treatment.</li><li>Imposing penalties on hospitals or agencies responsible for unnecessary delays.</li><li>Conducting regular audits of pre-authorization workflows.</li><li>Expanding auto-approval for more low-risk procedures.</li><li>Deploying AI-enabled case tracking to speed up approvals and improve transparency.</li></ul>

<h2>What is <span rel="noindex">Ayushman Bharat</span> PM-JAY?</h2>

Launched in September 2018, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is the world's largest government-funded health assurance program.

The scheme currently provides Rs 5 lakh per family per year for secondary and tertiary care hospitalization, covering around 12 crore families, representing the bottom 40 per cent of India's population.

It was later expanded to include around 6 crore senior citizens aged 70 years and above from 4.5 crore families, irrespective of their socio-economic status. The scheme also covers poor and vulnerable families, as well as gig and platform workers.

Last month, West Bengal became the 36th state to implement the Centre's flagship health insurance scheme.

Union Health Minister J.P. Nadda recently said one of the government's biggest achievements has been reducing out-of-pocket healthcare expenditure, which has fallen from 64.6 per cent before 2018 to 43.4 per cent. He added that AB PM-JAY has enabled timely access to quality healthcare through a cashless, paperless, and fully digital platform.

According to the government, the scheme has achieved the following milestones:

<ul><li>More than 44 crore Ayushman Cards have been created.</li><li>Over 12 crore hospital admissions have been authorized under the scheme.</li><li>Women account for nearly half of all beneficiaries.</li><li>More than 104 crore health records have been linked to over 93 crore ABHA accounts.</li></ul>

<h2>Universal health coverage by 2033</h2>

In March, Finance Minister Nirmala Sitharaman told Parliament that the government aims to achieve universal health coverage by 2033.

Addressing the Rajya Sabha, she said health insurance has become a priority area for the government, with the sector covering 58 crore lives during 2024-25, according to news agency PTI.

"Health insurance is a priority for this government. In fact, we are hoping that by 2033 we will have insurance cover for all," Sitharaman said.

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India's flagship health insurance scheme, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), which covers more than 62 crore people, could soon offer higher financial protection if a key parliamentary recommendation is accepted.A Parliamentary Standing Committee on Health and Family Welfare has recommended increasing the insurance cover under PM-JAY from the current Rs 5 lakh to Rs 10 lakh, according to a report by The Times of India.The committee said the existing coverage is inadequate to meet the cost of several life-saving treatments, including liver transplants, complex cardiac surgeries, and immunotherapy.Key recommendationsThe panel has proposed:Increasing PM-JAY health insurance coverage from ₹5 lakh to ₹10 lakh.Introducing special high-cost treatment packages for expensive procedures.Adopting a differential pricing model for complex and advanced medical interventions.Supporting higher coverage through:Pooled financingNegotiated pricing with hospitals and medical device manufacturersCo-funding mechanisms with states.Recommendations To Improve Cashless TreatmentTo improve the efficiency of the scheme, the committee also recommended:Strict enforcement of the six-hour turnaround time for pre-authorization of cashless treatment.Imposing penalties on hospitals or agencies responsible for unnecessary delays.Conducting regular audits of pre-authorization workflows.Expanding auto-approval for more low-risk procedures.Deploying AI-enabled case tracking to speed up approvals and improve transparency.What is Ayushman Bharat PM-JAY?Launched in September 2018, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is the world's largest government-funded health assurance program.The scheme currently provides Rs 5 lakh per family per year for secondary and tertiary care hospitalization, covering around 12 crore families, representing the bottom 40 per cent of India's population.It was later expanded to include around 6 crore senior citizens aged 70 years and above from 4.5 crore families, irrespective of their socio-economic status. The scheme also covers poor and vulnerable families, as well as gig and platform workers.Recent milestonesLast month, West Bengal became the 36th state to implement the Centre's flagship health insurance scheme.Union Health Minister J.P. Nadda recently said one of the government's biggest achievements has been reducing out-of-pocket healthcare expenditure, which has fallen from 64.6 per cent before 2018 to 43.4 per cent. He added that AB PM-JAY has enabled timely access to quality healthcare through a cashless, paperless, and fully digital platform.According to the government, the scheme has achieved the following milestones:More than 44 crore Ayushman Cards have been created.Over 12 crore hospital admissions have been authorized under the scheme.Women account for nearly half of all beneficiaries.More than 104 crore health records have been linked to over 93 crore ABHA accounts.Universal health coverage by 2033In March, Finance Minister Nirmala Sitharaman told Parliament that the government aims to achieve universal health coverage by 2033.Addressing the Rajya Sabha, she said health insurance has become a priority area for the government, with the sector covering 58 crore lives during 2024-25, according to news agency PTI."Health insurance is a priority for this government. In fact, we are hoping that by 2033 we will have insurance cover for all," Sitharaman said.

india's parliamentary panel calls for doubling ayushman bharat cover to rs 10 lakh

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India's Parliamentary Panel Calls For Doubling Ayushman Bharat Cover To Rs 10 Lakh

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India's Parliamentary Panel Calls For Doubling Ayushman Bharat Cover To Rs 10 Lakh

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