Ayushman Bharat: Impact and Future of India’s Largest Health Insurance Scheme

Ayushman Bharat, launched by the Government of India in 2018, is one of the world’s largest publicly funded health insurance schemes. Designed to provide healthcare access to economically vulnerable populations, this ambitious initiative has transformed the landscape of Indian healthcare. It not only offers financial protection against medical expenses but also strengthens primary healthcare infrastructure across the country.

In this article, we explore the impact of Ayushman Bharat, how it has changed the lives of millions, and what the future holds for this game-changing scheme.

What Is Ayushman Bharat?

Ayushman Bharat, officially known as Pradhan Mantri Jan Arogya Yojana (PM-JAY), aims to provide health coverage of up to ₹5 lakh per family per year for secondary and tertiary care hospitalization. It targets more than 50 crore beneficiaries, primarily the poor and vulnerable sections identified through the Socio-Economic Caste Census (SECC) data.

Key Features of Ayushman Bharat

• Coverage of ₹5 lakh per family per year
• Over 1.5 lakh Health and Wellness Centres (HWCs)
• Completely cashless and paperless services
• Pan-India portability—beneficiaries can access healthcare anywhere in India
• Covers 1,500+ medical procedures
• No cap on family size, age, or gender

Impact of Ayushman Bharat So Far

The scheme has been a lifeline for millions of Indians, especially those who could never afford quality medical treatment. Let’s look at the major impacts it has made.

1. Improved Access to Healthcare

One of the biggest achievements of Ayushman Bharat is that it has made healthcare more accessible to the poor. By removing the financial burden of hospitalization, many people now seek treatment at the right time rather than delaying or avoiding it due to cost.

• As of 2025, over 6 crore hospital admissions have been made under PM-JAY
• More than 26,000 hospitals (public and private) are empaneled under the scheme

2. Financial Protection

Medical expenses are one of the top causes of poverty in India. Ayushman Bharat protects vulnerable families from catastrophic health expenses. Beneficiaries no longer have to borrow money or sell assets to afford hospital treatment.

A recent study showed that families covered by PM-JAY saved an average of ₹25,000–₹40,000 per hospitalization.

3. Strengthening Primary Healthcare

Under the second pillar of Ayushman Bharat, more than 1.7 lakh Health and Wellness Centres (HWCs) have been set up. These centers provide:

• Basic diagnostic services
• Maternal and child health care
• Non-communicable disease screening
• Mental health services
• Essential medicines and wellness activities

This shift from treatment to preventive and promotive healthcare is expected to reduce disease burden in the long run.

4. Boost to Private Healthcare Sector

Ayushman Bharat has opened doors for private hospitals to serve rural and semi-urban populations. Many hospitals in Tier 2 and Tier 3 cities have seen an increase in patients and income due to empanelment under PM-JAY.

This has also encouraged new hospital infrastructure development in smaller towns.

Challenges and Criticism

While the Ayushman Bharat scheme is widely praised, it also faces some challenges and criticism that need attention.

1. Uneven Implementation

Health is a state subject, and the success of Ayushman Bharat varies across states. Some states like Gujarat, Karnataka, and Uttar Pradesh have embraced the scheme fully, while others like West Bengal and Odisha have either opted out or implemented their own versions.

This leads to inconsistencies in coverage and service quality.

2. Fraud and Abuse

There have been reports of fraudulent claims and misuse of the scheme. Fake hospital bills, ghost patients, and unnecessary procedures are some of the loopholes that need stricter monitoring and auditing systems.

3. Lack of Awareness

Many eligible families are still unaware of their entitlements under the scheme. This leads to underutilization in some regions. Grassroots awareness campaigns and digital outreach are essential to address this.

4. Inadequate Manpower

HWCs often suffer from a shortage of trained healthcare workers, diagnostic tools, and regular medicine supply. Without enough human and physical resources, the vision of preventive care remains incomplete.

Success Stories from the Ground

Sunita Devi, Bihar

Sunita, a daily wage laborer, had a serious gall bladder infection that required surgery. She visited a government empaneled hospital in Patna, and the entire cost of ₹48,000 was covered under PM-JAY. She says, “I didn’t pay even one rupee. Without Ayushman Bharat, I could never have done this surgery.”

Ramesh, Madhya Pradesh

Ramesh’s daughter was born with a heart defect. Thanks to Ayushman Bharat, she received free surgery at a top hospital in Indore. “My child got a second life. This scheme is a blessing,” says Ramesh.

Future of Ayushman Bharat

The government has ambitious plans to expand and improve Ayushman Bharat in the coming years. Here’s what the future roadmap looks like:

1. Digital Health Mission Integration

Ayushman Bharat is being integrated with the Ayushman Bharat Digital Mission (ABDM), which aims to create a digital health ecosystem for every citizen. Features include:

• Unique Health ID for each individual
• Digital health records
• e-Pharmacies and telemedicine

This will streamline healthcare delivery and reduce paperwork and fraud.

2. Expanding Coverage

There are talks of extending Ayushman Bharat coverage to:

• Non-poor vulnerable groups like gig workers, street vendors, etc.
• Urban middle class who often fall into the coverage gap between PM-JAY and private insurance
• New procedures and treatments including mental health, cancer care, and rehabilitation

3. More Empaneled Hospitals

The scheme aims to add more private hospitals in underserved regions, offering incentives to encourage participation.

The government is also pushing for quality standards and ratings for hospitals under PM-JAY to improve service delivery.

4. Skill Development for Healthcare Workers

To meet the growing needs of HWCs and PM-JAY beneficiaries, there’s a plan to train more frontline workers like nurses, midwives, and lab technicians. This will not only improve care quality but also generate rural employment.

Key Statistics (As of 2025)

Final Thoughts

Ayushman Bharat is not just a health insurance scheme—it’s a transformational movement in India’s healthcare journey. It reflects the nation’s commitment to universal health coverage and equity in access. While there are implementation challenges, the potential benefits far outweigh the limitations.

As digital infrastructure, awareness, and healthcare facilities improve, Ayushman Bharat will play a central role in shaping the future of healthcare in India. It is not just about curing diseases—it’s about restoring dignity, saving lives, and securing futures.

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