The flagship health scheme of the Centre ‘Pradhan Mantri Jan Arogya Yojana,’ (PM-JAY), popularly referred to as Ayushman Bharat, has received no boost in the Budget mostly due to low rate of utilisation of funds.
Finance Minister Nirmala Sitharaman stated that PM-JAY will receive ₹6,400 crore in FY 2020-21 from the Centre. In 2019-20, too, the same amount was allocated. The scheme insures poor families for an annual amount of ₹5 lakh for availing of hospital care.
PM-JAY CEO Indu Bhushan told BusinessLine that up to 30 per cent of the eligible beneficiaries from Socio-Economic Caste Census (SECC) of the originally estimated 50 crore individuals were untraceable, as SECC data was old, partly leading to poor utilisation. “Also, States like Uttar Pradesh, Bihar, Madhya Pradesh which have about 40 per cent beneficiaries are implementing the scheme for the first time leading to slow uptake.”
Department of Health and Family Welfare in the Ministry of Health has been allocated ₹65,011 crore and is yet not on track of achieving 2.5 per cent of the Gross Domestic Product target as envisioned in National Health Policy, while it had demanded close to double at ₹1.12 lakh crore. Add to this, ₹2,100 crore doled out to the Department of Health Research and ₹2,122 crore given to the Ministry of Ayurveda, Yoga, Unani, Siddha and Homeopathy, the Government has allocated ₹69, 233 crore towards health and related activities.
Allocation for the PM-JAY scheme has not increased because the Centre is unable to spend the allocated amount last year. Despite an allocation of ₹6,400 crore in 2019-20, the revised estimates were halved to ₹3,200 crore. According to an analysis by Accountability Initiative, release of funds was slow in 2019-20. By November 29 last year, only ₹1,014 crore or 16 per cent of 2019-20 allocations had been released.
“Release is done after we have ensured that the states have fulfilled certain conditions. We also need proof that the state share has been deposited. Also states are not only asking for past claims but also for future claims. However, funds have not been a problem,” Bhushan said.
In the case of Gujarat, Tamil Nadu, Andhra Pradesh, Rajasthan and Kerala, while the States had asked for a larger amount, the release of funds from the Centre were lower than the claims raised by the States. As a result, the percentage of claims ultimately paid was less than half in Rajasthan (44 per cent), Andhra Pradesh (41 per cent), Sikkim (39 per cent), Kerala (39 per cent), Karnataka (37 per cent) and Arunachal Pradesh (32 per cent), according to the analysis of data available in Lok Sabha.
A year earlier, during the inception of the scheme, in 2018-19, revised estimates for the PM-JAY stood at ₹2,400 crore.
In her Budget speech, Sitharaman also stated that Tier-II and -III cities have low number of private hospitals empanelled for PM-JAY and it is a barrier for poor people to gain access to medical care. Among the 112 aspirational districts, those that do not have a private hospitals empanelled for PM-JAY, a Public Private Partnership (PPP) model would be put in place for supporting district hospital infrastructure.
Giving district health facilities for PPP has already stirred a hornet’s nest in States like Madhya Pradesh and Chhattisgarh who have opposed the handover of district hospitals through PPP mode to build medical colleges, said Amulya Nidhi, convenor of Jan Swasthya Abhiyan, Madhya Pradesh.