SYLLABUS

GS-2: Government policies and interventions for development in various sectors and issues arising out of their design and implementation; Issues relating to development and management of Social Sector/Services relating to Health.

Context: West Bengal is set to become the 36th State/UT to implement the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), marking a significant step towards universal health coverage in India.

More on the News

• The National Health Authority (NHA) and the Government of West Bengal will sign a Memorandum of Understanding (MoU) for the implementation of AB PM-JAY, bringing the State under the ambit of the world's largest publicly funded health assurance scheme. 

• With the signing of the MoU, West Bengal will become the 36th State/UT in the country to implement the scheme.

• The inclusion of West Bengal is expected to provide financial protection against catastrophic health expenditure to millions of eligible beneficiaries and ensure portability of healthcare benefits across India. 

• The move will strengthen the State’s healthcare ecosystem by improving access to affordable and quality healthcare services through a network of empanelled public and private hospitals. 

About Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY)

• AB PM-JAY is a Centrally Sponsored Scheme under the Ayushman Bharat Mission, anchored by the Ministry of Health and Family Welfare. 

• The National Health Authority (NHA) is the apex body responsible for implementing the scheme. 

• It was launched on 23 September 2018 at Ranchi, Jharkhand, by Prime Minister Narendra Modi. 

• It is regarded as the world's largest publicly funded health assurance scheme. 

• The scheme supports about 15 crore poor and vulnerable families and around 55 crore beneficiaries. 

• Components of Ayushman Bharat

• Health and Wellness Centres (HWCs): Provide comprehensive primary healthcare services closer to people’s homes. Cover maternal and child health, communicable and non-communicable diseases, mental health, dental care, eye care and geriatric care. 
• Pradhan Mantri Jan Arogya Yojana (PM-JAY): Provides health insurance coverage for secondary and tertiary care hospitalization. 

• Key Features:

• Provides health cover of ₹5 lakh per family per year for hospitalization. 
• Covers pre-existing diseases from day one. 
• Includes 3 days of pre-hospitalisation and 15 days of post-hospitalisation expenses. 
• Offers cashless and paperless treatment at empanelled hospitals. 
• Benefits are portable across India. 
• No cap on family size or age for eligible beneficiaries. 

• Funding Pattern:

• General States: Centre (60): State (40). 
• North-Eastern and Himalayan States: Centre (90): State (10). 

• Eligibility: Covers poor and vulnerable families identified through the SECC database. 

• Includes rural and urban deprived occupational categories. 
• Covers all ASHA, Anganwadi Workers (AWWs) and Anganwadi Helpers (AWHs) and their families.

• Senior Citizen Expansion (2024): All citizens aged 70 years and above receive coverage regardless of socio-economic status. 

• Eligible senior citizens receive a distinct PM-JAY card. 
• Senior citizens already covered under PM-JAY families get an additional top-up cover of ₹5 lakh annually, separate from the family's existing cover. 
• Beneficiaries under Central Government Health Scheme (CGHS), Ex-Servicemen Contributory Health Scheme (ECHS), and Ayushman Central Armed Police Force (CAPF) can choose either their existing scheme or PM-JAY. 

Significance

• Strengthens Universal Health Coverage (UHC) by expanding access to affordable healthcare. 

• Reduces catastrophic health expenditure and out-of-pocket medical costs. 

• Improves healthcare accessibility through a nationwide network of empanelled hospitals. 

• Provides nationwide portability, allowing treatment across States. 

• Enhances financial security for senior citizens through expanded coverage. 

• Contributes to SDG-3 (Good Health and Well-being) and the principle of "Leave No One Behind".

Sources:
News on Air
The Print
Economic Times
Business Standard
Vikaspedia