New Delhi: The Ayushman Bharat health-insurance scheme has played a decisive role in the significant reductions observed in out-of-pocket expenditure through an increase in social security and primary health expenditure, with more than Rs 1.25 lakh crore in savings recorded, according to the Economic Survey 2024-25 that was tabled in Parliament on Friday.
The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) has revolutionised healthcare by providing a health coverage to the bottom 40 per cent of India’s most vulnerable populations, the survey said.
It covers more than 12 crore families or, approximately, 55 crore individuals and is the world’s largest health-insurance scheme, offering annual hospitalisation benefits of up to Rs 5 lakh per family for secondary and tertiary care.
Launched to address health inequities, the AB-PMJAY prioritises the poorest segments of the population based on the Socio-Economic Caste Census 2011, adopting a holistic and need-based approach, the report said.
It asserted that this initiative aligns with India’s commitment to the sustainable development goals (SDGs), ensuring that no one is left behind.
As of January 1 2025, more than 36.36 crore Ayushman cards have been issued, the report said.
It added that 30,000 hospitals, including 13,352 private facilities, are empanelled under the scheme. Also, 49 per cent of the cardholders are women and 48 per cent of hospital admissions are utilised by women.
On September 11, 2024, the expansion of the AB-PMJAY was approved to include senior citizens aged 70 and above, irrespective of their socio-economic status.
This initiative provides free health coverage of up to Rs 5 lakh per family, benefitting approximately six crore senior citizens across 4.5 crore families, regardless of income, the report said.
The eligible senior citizens will receive a dedicated Vay Vandana Card to access the scheme’s benefits.
Additionally, those already covered under the scheme will get an exclusive top-up of Rs 5 lakh annually for their healthcare needs, separate from their family’s coverage.
As of January 15, 2025, more than 40 lakh senior citizens have been enrolled under the scheme, the report said.
Other initiatives, such as the free-dialysis scheme, have benefitted around 25 lakh people, it highlighted.
“The reduction in OOPE goes hand in hand with increased public spending in healthcare, demonstrating progress towards universal health coverage,” it stated.
The increase in government spending on health has an important implication for the reduction of the financial hardship endured by households.
In the Total Health Expenditure (THE) of the country between Financial Year 2015 and FY 22, the share of government health expenditures (GHEs) has increased from 29 per cent to 48 per cent, the report said.
During the same period, the share of out-of-pocket expenditure (OOPE) in the THE declined from 62.6 per cent to 39.4 per cent, it underlined.
The government health insurance schemes constitute a 5.87-per cent share in healthcare-financing schemes, out of which social insurance schemes like the Employees’ State Insurance Corporation (ESIC), Central Government Health Scheme (CGHS) and Ex-Servicemen Contributory Health Scheme (ECHS) have a 3.24-per cent share.
The government-supported voluntary insurance schemes like the AB-PMJAY, Rashtriya Swasthya Bima Yojana (RSBY), state-specific government health-insurance schemes etc. Have a 2.63-per cent share in healthcare-financing schemes, the report noted.
Launched in 2018, Ayushman Bharat represents a paradigm shift from selective health services to a comprehensive continuum of care, addressing prevention, promotion and treatment across primary, secondary and tertiary levels.
By transforming sub-health centres (SHCs) and primary health centres (PHCs), Ayushman Arogya Mandirs (AAMs, formerly known as health and wellness centres) have been operationalised in rural and urban areas, offering a universal, free and expanded package of preventive, promotive, curative, palliative and rehabilitative services closer to communities.
More than 1,75,560 AAMs were operationalised till December 31, 2024.
The Universal Immunisation Programme (UIP) is one of India’s most-impactful public health initiatives, providing life-saving vaccines to millions of newborns and pregnant women annually. Launched as the Expanded Programme on Immunisation in 1978, it was re-branded as the UIP in 1985, extending the coverage from urban to rural areas to bridge healthcare disparities.
Currently, the UIP offers 11 vaccines free of cost, protecting against 12 vaccine-preventable diseases.
With full immunisation coverage for FY 24 at 93.5 per cent nationally, the UIP continues to safeguard public health and ensure equitable access to essential vaccines, the report stated.
The Jan Aushadhi scheme, launched to provide affordable medicines, has gained significant momentum, achieving record sales in 2024 and expanding to more than 14,000 kendras nationwide.
“Despite challenges like quality concerns, supply issues and thin profit margins for pharmacists, the scheme has improved access to low-cost drugs. Awareness campaigns, expanded product offerings like sanitary napkins and increased rural outreach have boosted its impact, particularly for low-income groups and those with chronic illnesses,” the report highlighted.
“While profitability remains a hurdle for pharmacists and suppliers, the growing demand by consumers highlights the enduring need for affordable healthcare solutions,” it added.
While the government’s health initiatives play a crucial role in improving access to healthcare and ultimately, enhancing health outcomes in the country, the overall health of a population is also affected by other socio-economic factors, the report pointed out.
These factors include sanitation, education, nutrition, early child development and personal habits, it said.
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