India's Union Government approves free healthcare coverage for senior citizens over 70 years and above

India is the most populous country in the world with over 1.4 billion people. Can the Indian government provide free healthcare assistance for all? Let's take a look. Well, the Scheme is called Ayushmann Bharat Pradhan Mantri Jan Arogya Yojana (AB PM - JAY) which translates into ‘long life’ in Sanskrit. Launched in 2018, the scheme was initially aimed at low-income groups such as poor and vulnerable families, offering them health coverage of ₹5 lakh per family per year. The cost of this cover is typically shared between the central and state governments.

Earlier this year, in April 2024, Prime Minister Narendra Modi announced the expansion of this scheme to include all senior citizens, regardless of their income or social status. Any Indian citizen aged 70 and above is now eligible for the scheme. According to government estimates, this expansion will benefit around 60 million people. Importantly, those already holding private health insurance can still benefit from Ayushman Bharat without affecting their existing policies.

Ayushman Bharat currently partners with a network of approximately 30,000 hospitals across India, of which over 12,000 are private. Senior citizens above age 70 years are the most vulnerable section of the society, they remain at the highest risk. 98% of senior citizens in India do not have a health cover which is both alarming and shocking.

Ayushman Bharat is a good start to give healthcare access to the country's senior citizens. The scheme is expected to support 45 million families, covering 60 million senior citizens. Those senior citizens who are already enrolled in public health insurance programmes such as the Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), or the Ayushman Central Armed Police Force (ACPF) will have the option to switch to the new Ayushman Bharat scheme if they prefer.

As of now, Ayushman Bharat remains the world’s largest government-funded health insurance scheme, covering 550 million people in 123.4 million families. This scheme has covered 73.7 million hospital admissions with 49 percent beneficiaries being women. Over ₹1 trillion has already been spent on healthcare services under this initiative. Initially, 107.4 million families from the poorest 40% of India’s population were included. However, this was later expanded to 120 million families in response to the country's 11.7% population growth over the past decade.

On the other hand, 72 out of 195 countries in the world have some kind of universal health coverage which can be classified into two broad models.

Let's take a look. In countries like United Kingdom, healthcare costs are entirely covered by the government and in other cases they fund healthcare through private and public contributions. For example, in Germany the employee and employer both contribute to a fund which is used collectively for healthcare. Private insurance is available for those who want it but all Germans get the same level of treatment.

In comparison, Ayushman Bharat has a limited fund of Rupees 5 lakh per family. If two members are above 70 years, his amount will be shared between them, a situation insurers refer to as a "family floater." The quality of care could differ from one hospital to another. Earlier this year some private hospitals reported delays in receiving payments from the Centre and State . According to them, the state governments weren't allocating enough funds for the health insurance scheme. This caused issues for the hospitals putting innocent people and their lives are at risk. At this crucial time, some hospitals may be reducing their services. In response, the Indian government has established a health insurance regulator to oversee both private and public insurance schemes.

Today over 400 million people don't have a health insurance policy. Almost 68% of those who have one don’t have enough funds to cover their medical expenses. The taxation of insurance premiums, which currently attract an 18% GST, has also sparked criticism from opposition parties, who have called on Finance Minister Nirmala Sitharaman to reduce or eliminate this tax.

Long story cut short, Ayushman Bharat is the beginning of a reset in India's healthcare. It’s a step in the right direction but we have a long way to go to make the universal healthcare accessible to 1.4 billion Indians. Achieving this will require sustained cooperation between both central and state governments. Let's see if we can make it happen.