The BJP’s recent victory in West Bengal means the state will finally join the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). This flagship health insurance scheme was designed to help the poorest families by providing coverage of up to ₹5 lakh.
Prime Minister Narendra Modi promised citizens in a speech that his party would focus on creating a better future for Bengal. He stated that AB-PMJAY would be approved in the first cabinet meeting.
This scheme, launched in 2018, is set to benefit more than 1.2 crore underprivileged residents and nearly 16 lakh elderly people aged 70 and above in West Bengal. Additionally, it will extend coverage to around 3 lakh ASHA and Anganwadi workers.
Interestingly, other states like Odisha and Delhi initially opted out of the scheme but eventually joined after BJP’s electoral victories there. Before this, West Bengal was part of AB-PMJAY but withdrew in 2019, accusing the central government of taking credit while placing a financial burden on the state. Instead, it maintained its own health insurance program called Swasthya Sathi.
Over the years, AB-PMJAY has evolved. States can now co-brand the scheme, integrating their local health programs. For example, Maharashtra has its PM-JAY-Mahatma Jyotirao Phule Jan Arogya Yojana, and Uttarakhand utilizes PM-JAY Atal Ayushman Uttarakhand Yojna.
In Delhi, the AAP government initially contested the scheme but later promoted its own, claiming it benefited all citizens—rather than just the poorest. Their Delhi Arogya Kosh program offers comprehensive care without any limits but still had fewer beneficiaries compared to AB-PMJAY.
What stands out is that states can add more beneficiaries beyond those identified by the central government. For these additional beneficiaries, the state has to cover the costs entirely, but they still get access to ₹5 lakh coverage. Since the scheme’s launch, states have added about 8.6 crore additional beneficiaries.
As of 2024, the government made a significant change by including coverage for elderly individuals aged 70 and above, offering the same ₹5 lakh coverage. This decision aims to ease the financial burden on older citizens, especially in states like Delhi and West Bengal, which had initially aimed to implement their own systems.
In a recent statement, PM Modi expressed regret over the political barriers preventing aid to elderly residents in these regions.
According to National Health Authority (NHA) data, the impact of AB-PMJAY has been notable, with over 10.6 crore hospital admissions across India, costing about ₹1.48 lakh crore since its inception. The scheme represents a fundamental shift in how healthcare is delivered in India, aiming for inclusivity and improved access, especially for marginalized communities.
This evolving landscape of health insurance in India not only highlights the importance of political support but also emphasizes the need for collaboration between state and central governments to ensure that every citizen can receive the healthcare they deserve.
For more detailed insights, you can check out this National Health Authority report.
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