The government can expand Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) coverage to the poorest segments of the missing middle population, and leverage the scheme’s infrastructure to offer a voluntary contributory enrolment, NITI Aayog, government’s policy think tank has recommended in a report released.
The report titled “Health Insurance for India’s Missing Middle”, brought out the gaps in the health insurance coverage across the Indian population and offers solutions to address the situation. The report highlights the need for designing a low-cost comprehensive health insurance product for the missing middle. It primarily recognizes the policy issue of low financial protection for health for the missing middle segment and highlights health insurance as a potential pathway in addressing that. In doing so, the report offers a starting point for broader discussions on solutions, and specific products, to improve insurance coverage for the missing middle.
The report noted that low government expenditure on health has constrained the capacity and quality of healthcare services in the public sector. It diverts the majority of individuals-about two-thirds-to seek treatment in the costlier private sector. However, low financial protection leads to high out-of-pocket expenditure (OOPE). India’s population is vulnerable to catastrophic spending, and impoverishment from expensive trips to hospitals and other health facilities. At least 30% of the population, or 400 million individuals-called the missing middle in this report-are devoid of any financial protection for health, the report said.
