Why in the news?

  • Annual report on AB-PMJAY released by National Health Authority.

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)

  • Launched: 2018 under the Ministry of Health and Family Welfare.
  • Implementing Agency: National Health Authority (NHA).
  • Objective: To provide universal health coverage for poor and vulnerable families by reducing catastrophic out-of-pocket expenditure.
  • Coverage: ₹5 lakh per family per year for secondary and tertiary care hospitalisation.
  • Nature: Cashless and paperless health insurance at both public and private empanelled hospitals.
  • Coverage & Expansion
    • Total Families Covered:
      • 15.14 crore eligible families under AB-PMJAY.
      • 8.57 crore additional families under State-specific schemes.
    • States/UTs Covered: 35 (except West Bengal).
    • Newly Onboarded (2024–25): Odisha and Delhi.
    • Empanelled Hospitals: 31,005 (55% public, 45% private).
    • Total Admissions: 9.19 crore hospitalisations worth ₹1,29,386 crore.
    • Ayushman Cards Issued: 40.45 crore cards, covering 14.69 crore families.
  • Gender and Inclusivity Milestones
    • Women’s Share in Admissions: 49% — indicates improved institutional health access for women.
    • Inclusion Initiatives:
      • Aapke Dwar Ayushman (ADA 3.0): Tech-enabled, community-based self-registration outreach.
      • 2023 Interim Budget: Inclusion of 37 lakh frontline worker families (ASHAs, Anganwadi workers & helpers).
      • October 2024 Expansion: All citizens aged 70+ included, irrespective of income or socio-economic category.
  • Top Medical Treatments Availed
    • Haemodialysis: 14% (highest share).
    • Multiple package treatments: 7%.
    • Acute febrile illness: 4%.
    • Acute gastroenteritis and cataract procedures: 3% each.
  • Significance
    • Strengthens India’s path towards Universal Health Coverage (UHC) under SDG 3 (Good Health and Well-being).
    • Promotes gender equity and inclusion of elderly and frontline workers.
    • Acts as a safety net against health-related poverty for millions of families.
    • Enhances federal cooperation through convergence of State and Central health insurance schemes.
  • Challenges
    • Awareness gaps in rural and remote regions.
    • Delayed reimbursements to private hospitals.
    • Quality variation across empanelled facilities.
    • Need for stronger fraud detection systems and data privacy frameworks.