Highlighting that at least 30 per cent of the population, or 40 crore individuals – referred to as the ‘missing middle’ – are devoid of any financial security for health, the NITI Aayog has suggested Prime Minister Jan Arogya Scheme (PMJAY) scheme should be extended. Cover a section of people without health insurance.
In a report titled ‘Health Insurance for India’s Missing Centre’, released on Friday, NITI Aayog said, “Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) was launched in September 2018, and the state government’s Extension plans provide comprehensive hospitalization cover. Up to the bottom 50 percent of the population – about 70 crore persons. About 20% of the population – 25 crore persons – are covered through social health insurance, and private voluntary health insurance. The remaining 30% of the population is devoid of health insurance; PMJAY has a higher actual untouched population due to existing coverage gaps and overlap between schemes.
The report recommends three models to increase health insurance coverage in the country.
The first model focuses on increasing consumer awareness about health insurance, while the second model is about “developing a modified, standardized health insurance product” such as ‘Arogya Sanjeevani’, launched by the Insurance Regulatory Development Authority of India (IRDAI). Gaya is a standardized health insurance product. ) in April 2020.
The report states that a “slightly modified version” of the standardized Aarogya Sanjeevani insurance product will help increase updates amid the ‘missing middle’.
Explaining the third model, the report states, “The third model extends government subsidized health insurance to a wider set of beneficiaries through the PMJAY scheme. Because of the limited ability to pay for the voluntary contributory model mentioned above, this model can be used for the missing middle segments, which remain open. This is the only model out of the three proposed that has financial implications… While this model assures coverage of poorer areas on the missing middle population, premature expansion of PMJAY may put more burden on the plan.
.