New Delhi: Finance Minister Nirmala Sitharaman Saturday slashed the budget of the country’s flagship health insurance scheme Ayushman Bharat for the ongoing fiscal to half.
The budget for the scheme, officially known as Pradhan Mantri Jan Aarogya Yojana (PMJAY), has been revised from Rs 6,400 crore to Rs 3,314 crore in the ongoing 2019-20 fiscal.
The allocation for the scheme in Union Budget 2020-21, however, has been retained at Rs 6,400 crore.
Sitharaman’s move to revise the allocation downwards is driven by the under-utilisation of funds, accompanied by their slow release and delay in patients’ validation, according a pre-budget analysis by New Delhi-based think tank Centre for Policy Research (CPR).
Until November 2019, only 16 per cent of the total allocated funds had been released, said the CPR analysis.
“There have been delays in beneficiary validation and low availability of empanelled hospitals, particularly in certain areas resulting in a mismatch between the need and utilisation of insurance services,” said Avani Kapur, a CPR fellow.
“The percentage of total claims exceeded the percentage of total releases. By 29 November 2019, Rs 1,014 crore or 16 per cent of FY 2019-20 allocations had been released,” added Kapur.
Focus on health insurance scheme
In the last four years, the Narendra Modi government’s allocations for “health insurance” have increased by more than 13 times courtesy Ayushman Bharat, which is hailed as the world’s largest health insurance scheme.
According to the CPR analysis, allocations for Rashtriya Swasthya Bima Yojana (RSBY) stood at Rs 471 crore in 2017-18. With the launch of PMJAY in 2018-19, allocations increased over five-fold to Rs 2,400 crore. The allocations for RSBY were subsumed under PMJAY.
In 2019-20, this was more doubled to Rs 6,400 crore, and has been kept so for the next fiscal too.
Slow release of funds
Apart from the delays in beneficiary validation and low availability of empanelled hospitals, the release of funds also remained slow throughout 2019-20, found the CPR analysis.
There are gaps between “the percentage of claims out of total claims submitted by hospitals within states and the percentage of releases out of total releases made to states”, said the analysis by Kapur and Ritwik Shukla, a CPR fellow.
The analysis found that “in Gujarat, Tamil Nadu, Andhra Pradesh, and Rajasthan, the percentage of claims out of total claims exceeded the percentage of releases out of total releases. The opposite was true for Maharashtra, Madhya Pradesh, and Assam”.
As on 20 November 2019, the percentage of claims paid was highest in Tamil Nadu (94 per cent), followed by Haryana (92 per cent) and Manipur (91 percent).
In contrast, the percentage of claims paid was less than half in Rajasthan (44 per cent), Andhra Pradesh (41 per cent), Sikkim (39 per cent), Kerala (39 per cent), Karnataka (37 per cent), Arunachal Pradesh (32 per cent), and Goa (less than 1 per cent).