Game-Changer for Healthcare: Parliamentary Panel Pushes for Doubled Ayushman Bharat Cover to ₹10 Lakh
A significant recommendation by the Parliamentary Standing Committee on Health and Family Welfare proposes to double the Ayushman Bharat health cover from ₹5 lakh to ₹10 lakh per family. This crucial move aims to alleviate the financial burden of soaring healthcare costs and make advanced medical treatments accessible to millions more, reinforcing India's commitment to universal health coverage.
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India’s healthcare landscape is on the cusp of a potentially transformative change. The Parliamentary Standing Committee on Health and Family Welfare, in its 172nd Report, has put forth a compelling recommendation to increase the health insurance coverage under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PM-JAY) from the existing ₹5 lakh to a substantial ₹10 lakh per family annually. This proposal, currently awaiting government consideration and approval, could significantly enhance financial protection and access to advanced medical care for millions of vulnerable families across the nation.
Understanding PM-JAY: The Current Landscape
Launched in September 2018, the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) stands as the world's largest government-funded health assurance program. It provides cashless health insurance coverage up to ₹5 lakh per family per year for secondary and tertiary healthcare services. The scheme primarily targets the bottom 40% of India's population, covering approximately 12 crore families.
Over the years, PM-JAY has played a pivotal role in reducing the financial burden of healthcare, facilitating millions of hospital admissions. As of January 31, 2026, the scheme had authorized 11.46 crore hospital admissions valued at ₹1.69 lakh crore, with over 43 crore Ayushman Cards issued nationwide. The scheme's reach was further expanded to include all senior citizens aged 70 and above, irrespective of their income, in 2024, providing them with a separate card and ₹5 lakh coverage.
The Panel's Groundbreaking Recommendation
The Parliamentary Standing Committee on Health and Family Welfare, in its 172nd Report, explicitly recommended doubling the insurance cover to ₹10 lakh. This recommendation stems from a critical assessment of the current healthcare scenario and the financial challenges faced by beneficiaries. The committee reiterated its earlier suggestion for this increase, highlighting the urgency of the matter.
Why the Increase? Addressing Rising Healthcare Costs
The primary driver behind this recommendation is the undeniable reality of escalating healthcare costs in India. The committee observed that the existing ₹5 lakh limit is frequently insufficient to cover the expenses of several advanced and life-saving medical procedures. Treatments such as liver transplants, complex cardiac surgeries, and immunotherapy often incur costs far exceeding the current coverage ceiling, forcing beneficiaries to bear significant out-of-pocket expenses despite being enrolled in the scheme.
Medical inflation in India is estimated to be between 12-14% annually, ranking among the highest globally. This steady rise in expenses, coupled with advancements in medical technology and newer therapies, has rendered the existing coverage inadequate for many critical illnesses, including various cancers, cardiovascular disorders, and neurological conditions.
Potential Impact and Benefits
If implemented, the enhanced insurance limit of ₹10 lakh could bring a multitude of benefits:
- Enhanced Access to Advanced Treatments: Beneficiaries would be able to access complex and high-cost medical interventions, such as organ transplants and advanced cancer therapies, without the fear of exhausting their insurance cover.
- Reduced Financial Burden: Doubling the cover would significantly reduce out-of-pocket expenditure for critical illnesses, preventing millions of families from falling into debt due to medical emergencies.
- Improved Health Equity: The move would strengthen universal health coverage goals, ensuring that financial limitations do not prevent vulnerable populations from receiving necessary and quality medical care.
- Greater Trust in Public Health Initiatives: A more robust insurance cover could reinforce public trust in government-funded health schemes, encouraging wider participation and utilization.
Beyond the Cover: Other Key Recommendations
The parliamentary panel's report extended beyond just the financial cover, offering crucial recommendations to improve the overall efficiency and effectiveness of the PM-JAY scheme. These include:
- Faster Treatment Approvals: Strict enforcement of a six-hour turnaround time for approving cashless treatment requests, with penalty provisions for unnecessary delays by hospitals or agencies.
- Process Optimization: Periodic audits of the pre-authorization workflow, expansion of auto-approval for low-risk procedures, and the deployment of AI-enabled case tracking to speed up approvals and enhance transparency.
- Differential Treatment Cost Model: Introducing a differential treatment cost model for high-cost and complex procedures to better align PM-JAY coverage with current healthcare costs.
- Intensified Enrollment Drives: Stepping up Ayushman Card enrolment drives across the nation, especially in areas with weaker internet connectivity, and encouraging greater private hospital participation.
- Age Criteria Rationalization: Suggesting a reduction in the age criteria for Ayushman Vay Vandna Cards to 60 years and above, irrespective of socio-economic status, to widen the scheme's reach among seniors.
Funding the Future: Challenges and Strategies
Doubling the health cover naturally brings questions about funding. Official sources previously indicated that increasing the coverage to ₹10 lakh and expanding the beneficiary base to 100 crore individuals would require an additional annual allocation of approximately ₹12,076 crore. The committee has suggested several funding mechanisms to maintain fiscal sustainability, including pooled financing, negotiated pricing with hospitals and manufacturers, and co-funding arrangements with state governments. These strategies aim to balance enhanced patient benefits with responsible financial management.
The Road Ahead
While the Parliamentary Standing Committee on Health and Family Welfare has made a strong recommendation, it is important to note that this proposal still requires consideration and formal approval by the government. The ultimate decision will impact millions, moving India closer to its ambitious goal of achieving universal health coverage by 2033, as articulated by the Finance Minister in March. The potential doubling of the Ayushman Bharat health cover represents a significant step towards a healthier, more financially secure future for India's most vulnerable citizens.