Apr 2008๐ Backgroundtap to expand
RSBY launched as the first national health scheme
Rashtriya Swasthya Bima Yojana provides 30,000 rupees of inpatient cover for below-poverty-line families, the conceptual ancestor of PM-JAY.
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Ayushman Bharat: 55 crore Indians insured, but are hospitals actually delivering?
PM-JAY is the world's largest government health insurance scheme, covering 55 crore Indians for up to 5 lakh rupees a year. Six years of data reveal what works, what doesn't, and who still falls.
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PM-JAY at a glance
Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, launched in September 2018, is the world's largest publicly funded health insurance scheme. It now covers around 55 crore Indians, or about 12 crore eligible families, for up to 5 lakh rupees of secondary and tertiary inpatient care per year. NITI Aayog data through 2024 shows over 7.5 crore hospital admissions used under the scheme, with cardiac, oncology and orthopaedic procedures topping the list. Independent studies, including a 2023 Lancet Regional Health paper, find a modest but real reduction in catastrophic health expenditure among beneficiaries who actually accessed the scheme. The flip side is that empanelment is uneven, private hospital denial rates remain high in some states, outpatient care and diagnostics are not covered, and many of the poorest still pay out of pocket for routine illness that never crosses the inpatient threshold.
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Why India needed PM-JAY and what shaped it
Before 2018, India had one of the highest out-of-pocket health expenditures in the world. National Sample Survey data showed that roughly 60 percent of household healthcare costs came directly from the pocket of the patient's family, and an estimated 6 to 7 crore Indians fell into poverty every year because of a single hospital bill. State schemes like Aarogyasri in Andhra Pradesh and Yeshasvini in Karnataka had proved that publicly funded insurance could buy inpatient care from private hospitals at controlled rates. Building on this evidence, the government launched PM-JAY in 2018 as the inpatient pillar of a wider Ayushman Bharat strategy. It deliberately bundled empanelment of private hospitals, IT-enabled claims and a national portability promise so that a migrant worker from Bihar could access care in Delhi or Mumbai using the same beneficiary card linked to their socioeconomic caste census entry.
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Ayushman Bharat in numbers
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