Public healthcare as we know it is anticipated to change drastically with the Union Cabinet’s decision to expand the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) to include health coverage to anybody aged 70 and beyond, regardless of economic level. It also allays the fears of India’s rapidly aging population, who struggle to control the weight of illness due to the exorbitant expense of medical care, medications, and therapies in the absence of a social safety net.
At the moment, the income-based program covers all members of qualifying families, who are thought to make up the poorest 40% of the population, for a shared yearly coverage of Rs 5 lakh, regardless of age. All people 70 years of age and older will receive Rs 5 lakh in annual coverage per household after the Cabinet approves the scheme’s extension. A government statement states that an extra 6 crore individuals in this age bracket, from 4.5 crore families, are anticipated to benefit. A new card under PM-JAY will be given to the qualified recipients.
Can this scheme be beneficial to all 70-year-olds?
According to the government, senior persons who are 70 years of age or more and who are part of a family that is currently covered by AB PM-JAY will receive an extra (shared) top-up coverage of up to Rs 5 lakh annually for themselves.
People who are currently receiving benefits from other public health insurance programs, including as the Ayushman Central Armed Police Force (CAPF), Ex-Servicemen Contributory Health Scheme (ECHS), or Central Government Health Scheme (CGHS), can choose to enroll in AB PM-JAY or keep their current plan.
Benefits will be available to senior individuals who are 70 years of age or older and covered by either the Employees’ State Insurance Scheme or private health insurance coverage.
IS EVERY SENIOR CITIZEN IN A FAMILY COVERED BY THE SCHEME?
The eligible beneficiaries of a household will split the health coverage in such a case, as revealed by Union Minister of Information and Broadcasting Ashwini Vaishnaw. A family with two senior individuals (70 years of age or older) will split the Rs 5 lakh coverage between them. In light of India’s shift to nuclear families, this is a significant step toward guaranteeing the social security of senior folks, he said.
WHY IS THIS A SIGNIFICANT SCHEME?
Although the goal of the Ayushman Bharat programme was to provide universal health coverage, this age group will be the first to have full coverage.
HOW MUCH WILL THE GOVT HAVE TO PAY TO IMPLEMENT THIS HEALTH SHIELD?
The program will require an initial outlay of Rs 3,437 crore. “This is a demand-based scheme; coverage will increase in line with demand,” Vaishnaw stated.
According to sources, the Center is expected to bear 90% of the cost for states in the Northeast and hilly regions, while the majority of states would contribute 40% of the total cost. The specifics will be ironed out later. Once a choice has been made, it will occur during the implementation phase, according to a top official.
According to expert estimates, covering the poorest 40% of people in all age categories would be less expensive than extending coverage to everyone over 70.
WILL THE HEALTH COVER MINIMISE THE DISEASE BURDEN?
The Longitudinal Ageing Study in India predicts that the proportion of people over 60 in India will rise from 8.6% in 2011 to 19.5% in 2050 (LASI). The population of people over 60 is expected to quadruple from 103 million in 2011 to 319 million in 2050, expressed in absolute figures. The India Ageing Report 2023 states that the current rate of health coverage in this age group is roughly 20%.