Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) has transformed health care access in India since its launch in 2018. By August 2025, it has authorised over 10.3 crore hospital admissions, providing ₹1.48 lakh crore in cashless treatment. The scheme protects 61 crore people, reducing out-of-pocket expenses and improving health outcomes nationwide.
Origins and Vision
The scheme was launched to provide annual health cover of ₹5 lakh to vulnerable families. It aims to ensure no citizen is denied quality health care due to financial constraints. The Prime Minister’s personal involvement shaped the scheme’s design and continuous improvement.
Coverage Expansion
Initially covering 10 crore families, the beneficiary base increased to 12 crore by 2022. In 2024, Ashas, anganwadi workers, and their families were included. Citizens above 70 years gained coverage regardless of income via the Ayushman Vay Vandana Card. Nearly one crore gig and platform workers were also added, broadening the scheme’s reach.
Financial and Health Impact
The scheme drastically cut out-of-pocket medical expenses. Studies show a 90% increase in timely cancer treatment initiation within 30 days of diagnosis for beneficiaries. States adopting PM-JAY have witnessed sharper declines in infant and under-five mortality rates compared to non-adopting states.
Public and Private Hospital Participation
Over 32,900 hospitals are empanelled, including 15,100 private facilities. This mix ensures specialised care reaches the poor. Private investment in health care has grown, especially in smaller towns, reducing regional disparities. Public hospital upgrades complement this network.
Digital Health and Fraud Control
A sophisticated IT system supports beneficiary identification, e-claims, fraud detection, and portability across states. Fraud remains minimal at 0.33% of authorised admissions. A three-tier grievance redressal system enhances accountability and trust.
Integration and Future Priorities
The scheme aims to integrate more closely with primary health care. Strengthening referral chains and maintaining longitudinal digital health records are priorities. Timely payments to hospitals will sustain provider trust. Increasing private hospital empanelment in underserved areas remains a focus. West Bengal’s inclusion is awaited.
Significance and Scale
PM-JAY is the world’s largest health assurance programme. It symbolises India’s commitment to universal health coverage. The scheme empowers vulnerable populations and recognises frontline health workers’ contributions. Its continuous evolution reflects a national resolve to provide equitable, quality health care.
Questions for UPSC:
- Critically discuss the role of government health insurance schemes in achieving Universal Health Coverage in India with examples from Ayushman Bharat PM-JAY.
- Analyse the impact of public-private partnerships in healthcare delivery in India. How do schemes like Ayushman Bharat PM-JAY influence these partnerships?
- Examine the challenges and opportunities of integrating digital health technologies in India’s healthcare system. Discuss in the light of Ayushman Bharat PM-JAY’s IT infrastructure.
- With suitable examples, discuss the importance of social protection mechanisms for informal and gig economy workers in India’s healthcare framework.
