The government think tank NITI Aayog is working towards evolving a scheme to cover the segment of the population, which currently does not fall under the government-backed health insurance scheme, Ayushman Bharat-PMJAY.
PMJAY, launched in September 2018, covers the bottom 40% of the population, which numbers around 500m. The scheme provides medical insurance cover of up to INR500,000 ($7,000) per family per year,
NITI Aayog says in its 2019-20 annual report released earlier this month that it is looking at a health insurance plan to cover those who are characterised as not poor and are often referred to as the “deprived above-poverty-line class”.
This segment of the population, despite having the financial capacity to contribute to an insurance plan, remains prone to catastrophic health expenditure that can essentially push them below the poverty line. A large part of this sandwiched class is engaged in the informal sector and mostly based in urban areas.
Considering the urgent need to provide access to hospital care—particularly secondary and tertiary care for the poor and the excluded sections of the society—NITI Aayog, in consultation with private health insurers, is also working towards leveraging the capacity available with private players in the healthcare sector.
The report says that with the launch of PMJAY and 500m beneficiaries, there will be a need for 640,000 additional hospital beds over the next 10 years focusing primarily on Tiers 2 and 3 cities. Currently, India has over 14,000 hospitals with 634,000 beds.
NITI Aayog says that private players (both for profit and not for profit) have a key role to play in bridging the supply–demand gap in healthcare infrastructure while advancing standards of care.