NEW DELHI: To achieve universal health coverage, a parliamentary panel has recommended Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) coverage to be extended to all children below five years of age and all senior citizens aged 60 years and above.
The department-related parliamentary standing committee on health and family welfare said that AB-PM-JAY should be provided to children and elderly “irrespective of their socioeconomic status or geographical location.”
The panel made the recommendation as it felt that “universalisation is a pivotal step toward advancing Universal Health Coverage (UHC) and mitigating the disproportionate financial burden associated with childhood and geriatric illnesses.”
“To operationalise this effectively, the committee further recommends that the ministry ensure adequate financial provisioning, establish seamless enrolment mechanisms, and build robust synergy with existing child and elderly health programs to guarantee equitable, timely, and affordable healthcare services to every eligible beneficiary,” said the report.
It also suggested that “it is imperative that the scope of existing public health insurance frameworks, such as PMJAY, be broadened to comprehensively encompass outpatient consultations, diagnostic evaluations, medicine costs, and post-hospitalisation care.”
The government’s flagship programme, which was launched in 2018, provides coverage of `5 lakh per family per year for secondary and tertiary hospitalisation to over 500 million beneficiaries. The scheme later extended coverage to more than 37 lakh Accredited Social Health Activists (ASHAs), Anganwadi Workers and Anganwadi Helpers and their families, a workforce predominantly comprising women. It also extended coverage to senior citizens aged 70 years and above.
Highlighting it as a “major stride towards universal health coverage,” the committee, headed by Prof. Ram Gopal Yadav, said that the government has extended AB-PMJAY to all senior citizens aged 70 years and above, irrespective of socio-economic status.
However, the panel said the private sector absorbs a significant portion of PM-JAY funds due to enduring deficiencies in public tertiary care. “The committee believes that to build long-term systemic resilience and reduce dependency on private facilities, the public sector’s absorptive capacity must be drastically improved to enable public sector hospitals as tertiary care providers.”
In its report last month, the 31-member committee recommended aggressive, fast-tracked execution of the PM-ABHIM.
