NEW DELHI: Over 80 per cent of people with disability, especially those who have Haemophilia and multiple disabilities, in the country, lack health insurance, while 42 per cent have not even heard of the central government’s flagship programme, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), a latest nationwide survey has found.
The survey, conducted by the National Centre for Promotion of Employment for Disabled People (NCPEDP), a disability rights group, surveyed 5,000 people with disabilities living in 34 states and union territories, said that people with disability (PwD) face systemic barriers, unequal access to health insurance, and deep disparities in representation.
Calling for urgent attention and policy changes to ensure universal access to healthcare benefits for persons with disabilities, the survey advocated for the inclusion of all persons with disabilities under the PM-JAY without income and age restrictions.
Moreover, the survey flagged gender discrimination against women, with many finding themselves outside the health insurance coverage.
But what stood out in the survey was that a staggering 80.5% of respondents did not have health insurance from either private or government providers.
Data showed that a significant portion of PwD, particularly those with Thalassemia and Locomotor Disabilities, are either excluded from health insurance or unable to afford it.
However, a worrying finding was that only slightly more than half of the respondents with disabilities were aware of the central government’s flagship AB-PMJAY scheme, which is designed as the universal health insurance scheme for India and is touted as the world’s largest.
The survey found that only 58.8% have heard or are aware of the scheme, while a staggering 41.2% of respondents with disabilities had no idea about it.
71% of the respondents have never applied for any health insurance policies.
“These numbers aren’t just a statistic; they represent real people left behind by the system. Health insurance is not a privilege for persons with disabilities; it’s a necessity for survival,” said Arman Ali, Executive Director of NCPEDP.
Out of the 5,000 respondents surveyed, only 28.4% have applied for health insurance, and within that small section of respondents, only 46.8% could secure a health insurance policy.
A staggering 53.2% of respondents have not been able to secure a policy because their applications are being rejected.
Of those with insurance coverage, over 53% opted for the PMJAY scheme, followed by private insurance schemes (27%) and state government schemes (9%).
“This points to a serious systemic issue within the insurance policy landscape. The lack of awareness about the insurance scheme within the PwD community highlights the lack of information dissemination by the state machinery and other stakeholders involved. Lack of information trickling down to the grassroots has prevented a huge section of Persons with Disabilities from even applying for insurance schemes in the first place, even if they meet the eligibility criteria,” the survey pointed out.
The survey found that women who had insurance were predominantly from the Thalassemia category (46.6%), followed by locomotor disabilities (16.4%) and sickle cell disease (14.5%).
However, PwD women who have Haemophilia, dwarfism, multiple disabilities, and speech and language disability found less insurance coverage.
“There is a need to address the gender disparities within the disability community by advocating for policies that ensure equal representation, particularly for women in marginalized disability categories. This indicates gross inequality in insurance access and points out the existence of severe accessibility barriers in securing health insurance policies,” the survey said.
The survey also said that PwD faces accessibility barriers even when he/she qualify for a health insurance policy.
The high rejection rates were of those suffering from Thalassemia and Locomotor Disabilities.
The survey said there were many reasons for rejections. While some applications were rejected due to the exclusion of disability-related healthcare needs in the insurance assessments, in other cases, the applicants often did not receive any response or follow-up from insurance companies. Also, due to pre-existing conditions (36%) and lack of knowledge among insurers about disability-specific issues (32%) led to rejection.
Also, of the 53.2% of respondents whose applications were rejected, around 60% were not informed about the reasons for the rejection.
Ali said the National Disability Network (NDN), a coalition of organisations representing people with disabilities led by NCPEDP, has consistently advocated for the inclusion of people with disabilities under Ayushman Bharat without any income or age criteria.
The group has urged the central government to extend unconditional coverage as high healthcare costs, inflation, and inaccessible insurance services continue to push people with disabilities into deep financial distress.