Ayushman Bharat scheme may also include gig workers

NEW DELHI: The National Health Authority (NHA) plans to extend health insurance cover under the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (ABPM-JAY) to gig workers earning between Rs 15,000 to Rs 25,000 per month and other such groups, a top government official said.

At a recent meeting, the board members of NHA stressed the need to extend the health insurance cover to gig economy workers who have unstable incomes and often face financial ruin because of high out-of-pocket hospitalization costs. NHA has quotations for premier from some insurance firm to take its initiative forward, the official said, requesting anonymity.

ABPM-JAY, launched in September 2018, covers around 500 million poor beneficiaries (107.4 million families) based on the Socio-Economic Caste Census (SECC 2011) database. However, states implementing the scheme have expanded the beneficiary base to an additional 140 million families, covering around 700 million people. That leaves around 400 million Indians, or the so-called missing middle, without any form of financial protection for their health needs.

NITI Aayog defines the segment as the missing middle because they are not poor enough to be covered by government-subsidized insurance schemes and not wealthy enough to buy private insurance cover. “NHA has been given the mandate to expand coverage under ABPM-JAY to sections of society, including the non-poor segment, which is commonly referred to as the missing middle on the basis of self-payment or payment by some organizations. For example, these groups can be street vendors identified under PM Svanidhi Yojana, smaller sugarcane farmers and their workers who are associated with sugarcane cooperatives, workers of All India Truck Drivers Association etc.,” the official said.

Nearly 70% of India’s population is now estimated to be protected by some health insurance schemes, including those run by state governments, social insurance schemes and private insurance plans, a NITI Aayog report said. This includes around 20% of the population, or 250 million people, who are covered through social health insurance, and private voluntary health insurance, the report said.

“To protect the ‘near-poor’ and the middle class from impoverishing health expenditure, existing government health insurance programmes must be expanded. If needed, all sections which are currently not included may be provided with an opportunity to become beneficiaries of government schemes through income graded premiums,” said Dr K. Srinath Reddy, President, Public Health Foundation of India (PHFI).

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