The Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY) continues to play a critical role in improving access to healthcare for economically vulnerable sections of society, even as discussions grow around implementation efficiency and hospital participation.
Launched with the objective of reducing out-of-pocket medical expenses, the scheme provides cashless health insurance coverage for secondary and tertiary hospitalisation. Beneficiaries are entitled to treatment at empanelled public and private hospitals across the country, making it one of the largest publicly funded healthcare programmes in the world.
According to government officials, the scheme has helped millions of families access quality medical care for serious illnesses, including cardiac procedures, cancer treatment, and major surgeries. The portability feature of PM-JAY allows beneficiaries to receive treatment outside their home state, a provision that has proven especially useful for migrant workers and urban poor populations.
However, challenges remain. Experts point out that while enrolment and usage numbers have steadily increased, participation from large private hospitals is uneven in some regions. Hospital administrators have cited concerns over treatment package rates and delayed reimbursements, issues that authorities say are being addressed through periodic revisions and improved digital monitoring.
State governments have also played a key role in expanding the scheme’s reach by integrating PM-JAY with their own health insurance programmes. This convergence model has allowed states to offer higher coverage limits and include additional beneficiary groups beyond the original eligibility criteria.
Health policy analysts note that Ayushman Bharat has shifted the focus of public healthcare from out-of-pocket spending to insurance-based access, marking a significant structural change in India’s healthcare financing. At the same time, they stress the need for continued investment in primary healthcare infrastructure to reduce the burden on hospitals.
As healthcare costs continue to rise, the success of Ayushman Bharat will depend not only on funding allocations but also on effective implementation, transparency, and cooperation between governments, hospitals, and beneficiaries.
