A meeting of senior officials of the Centre and State governments to discuss the implementation of the mega health insurance scheme announced in the Budget is scheduled to kick-off in about 10 days’ time to give a concrete shape to the ambitious programme.

“We have intimated most States on the proposed meeting which will take place in the Capital. It is tentatively scheduled either on March 16 or March 19. We are trying to speed up things as much as possible so that the implementation of the scheme can be finalised,” a NITI Aayog official told BusinessLine .

The Narendra Modi-government wants to launch the National Health Protection Scheme — the insurance scheme with a ₹5 lakh cover each for 10 crore poor families — either on August 15 (Independence Day) or on October 2 (Mahatma Gandhi’s birth anniversary), but a lot of work needs to be done, including reaching an agreement with all States on the details and management of the scheme.

The scheme is being driven by NITI Aayog and the Health Ministry.

The biggest stumbling block the scheme may face is on the finance front as States need to contribute 40 per cent of the total cost estimated at about ₹10,000 crore-₹ 11,000 crore annually.

When asked what option the Centre has if certain larger States (which do not fall under the category of special States that are required to contribute 10 per cent of the bill) express their inability to foot the entire bill, the official said it would be for the Finance Ministry to decide if it could shoulder a larger share of the expense for such States.

“The decision for additional funding to help certain States would vest completely with the Finance Ministry,” the official said.

Model to be adopted

Another important decision to be taken at the State level will be on the model to be adopted — whether it should be insurance-based or trust-based. “In the trust-based model, State-run trusts will control the funds contributed by the Centre and States and will process and settle claims of hospitals that provide such services to the poor, instead of insurers. States have to indicate their preference,” the official said.

Additionally, States like Tamil Nadu, with successful insurance schemes of their own, will have to be convinced to merge their schemes with the Central scheme as two large-scale schemes will not be viable.

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