The National Health Authority (NHA), which implements government-run cashless health scheme — Pradhan Mantri Jan Arogya Yojana (PM-JAY), popularly referred to as ‘Ayushman Bharat’, has sought ₹7,915 crore from the Finance Ministry in 2020-21. The Union Budget is expected to be announced on February 1, 2021.

PM-JAY provides an annual health cover of ₹5 lakh for close to 10 crore poor families in the country.

Since the launch of the scheme in September 2018 up till March 2019, up to 14.57 lakh patient claims were submitted under PM-JAY, of which 10.15 lakh claims were paid out. Since April 2019 till date, 46.76 lakh claims have been submitted, which is a three-fold jump over last financial year, of which 24.34 lakh claims have been paid out till date. According to statistics obtained from NHA, in 2018-19, ₹1,849.55 crore were released, out of which ₹1,723.66 crore was for implementation purpose and ₹125.89 crore was for administrative expenses. In 2019-20, till date, ₹1,053 crore has been released — ₹1,011.95 crore for implementation and ₹41.05 crore for administration purposes.

Businessline had earlier reported that NHA had demanded ₹9,000 crore last year, during the first year of the scheme and had been sanctioned close to ₹6,400 crore in 2019-20. Officials were expecting a downward revision in demand this year around too.

Lower funds were sanctioned last year, after the Ministry of Health and Family Welfare (MoHFW) had raised an objection saying that NHA budgets were eating into other schemes. Despite the Health Ministry’s demand for ₹80,000 crore, only ₹62,398 crore were sanctioned for 2019-20, by the Finance Ministry.

Given that the health budget is unlikely to see a substantial increase, a tussle over the limited pool of funds within various schemes of the Ministry including that for PM-JAY is expected.

Senior officials said that in meetings with the MoHFW, the NHA officials were asked to pare down their revised estimates for PM-JAY in 2019-20 by close to ₹1,200 crore.

Conservative estimates

“The MoHFW officials requested us to send conservative revised estimates for expected expenditures up till March 2019 for the scheme. So we pared down our estimates to ₹5,200 crore, so that MoHFW can fill up the deficit elsewhere, for example, giving salaries to doctors of upcoming All India Institute of Medical Sciences (AIIMS),” a NHA official said.

The Health Ministry confirmed that AIIMS in Rishikesh, Bhubaneshwar, Raipur, Patna, Jodhpur and Bhopal were growing at a rapid pace and that earlier expenditure estimates submitted last year, have been upwardly revised.

“We have spent close to ₹4,250 crore towards AIIMS in 2019-20, in addition to ₹3,500 crore HEFA loan availed from Ministry of Human Resources and Development. While we were expecting a growth of 20-25 per cent last year, and had submitted conservative estimates to the Ministry of Finance last year, 70 per cent work at these institutions has been finished, so we need more funds,” an official monitoring the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) which commissions AIIMS said .

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