The Cabinet on Wednesday approved the government’s ambitious Ayushman Bharat — National Health Protection Mission, a part of which promises an annual insurance coverage of Rs 5 lakh for 10 crore families.
“The target beneficiaries of the proposed scheme will be more than 10 crore families belonging to poor and vulnerable population based on socio-economic caste census database,” the government said in a tweet after the Cabinet meeting.
It also cleared a proposal for the continuation of the National Health Mission, with effect from April 1, 2017 through March 31, 2020, with a budgetary support of Rs 85,217 crore as the central share over the period.
“AB-NHPM will subsume the ongoing centrally sponsored schemes — Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS),” an official statement read.
Presenting the Budget 2018-19, finance minister Arun Jaitley had announced two major initiatives in health sector, as part of Ayushman Bharat programme: health and wellness centre and the National Health Protection Scheme (NHPS), the latter is supposed to be the world’s largest government-funded health care programme. NHPS will cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage up to Rs 5 lakh per family per year for secondary and tertiary care hospitalisation, he had said.
The fully-government-funded NHPS is expected to cost Rs 10,000-12,000 crore a year, according to a government estimate. The Centre and states will share the cost in a ratio of 60:40.
The premium per family could be Rs 1,000-1,200 a year, which, the government expects, to be even lower with an open tender process. The government currently pays a premium of Rss 750 per family per annum for Rashtriya Swasthya Bima Yojana (RSBY). However, insurance companies have reportedly written to the government, citing their inability to bid for the NHPS due to grossly inadequate premiums. They say an annual premium of at least Rs 2,500 per family needs to be considered and states must pay the money to the companies in advance every year.
The government pays a premium of Rs 750 per family per annum for its current health insurance scheme, the Rashtriya Swasthya Bima Yojana. The scheme will give states the option to adopt insurance company or a trust model as followed under the Central government health insurance scheme. Some states are already having their own insurance models or are running trust-model health schemes. All existing health insurance schemes will be merged with NHPS finally.