News Life and Health26 Mar 2018

India:Modicare targeted to be launched before 15 August

26 Mar 2018

The government is keen to launch the Ayushman Bharat-National Health Protection Mission (AB-NHPM), dubbed 'Modicare' and deemed the world's largest public funded health insurance scheme, before 15 August, which is Independence Day in India, according to local media reports.

Last week, Health Minister JP Nadda said the government planned to complete all pre-launch activities, including testing of the information technology systems for the AB-NHPM, by the end of July.

Among the various operating models proposed for Modicare, states have the option to implement the scheme through an insurance company, the central government said. States can also opt to implement the scheme through a trust, society, not-for-profit company or health agency, or even choose a hybrid model.

The health insurance scheme, announced in the national Budget in February, aims to provide coverage of up to INR500,000 (US$7,700) to over 100 million poor families or 500 million people.

The government will set up an AB-NHPM Authority, headed by a full-time CEO of the level of Secretary/ Additional Secretary to the Government of India. The government hopes to appoint the CEO in April. Hospital empanelment is expected to be completed by end-June.

This cover will take care of almost all secondary care and most tertiary care procedures. There is no cap on family size and age in the scheme, ensuring that nobody is left out. The insurance scheme also covers pre and post-hospitalisation expenses. All pre-existing conditions will be covered from Day One. Furthermore, beneficiaries will also be paid a defined transport allowance per hospitalisation.

The AB-NHPM, when it kicks-in, will subsume two on-going centrally sponsored schemes, the Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS). RSBY was launched in 2008 by the Ministry of Labour and Employment and provides cashless health insurance, with a benefit coverage of INR30,000 per annum on a family floater basis [for five members], for below-poverty-line families, and 11 other defined categories of unorganised workers.

Both the Centre and the various state governments will pay for the scheme. The programme will require an estimated INR100 billion for the next two financial years starting 1 April 2018. Getting all the state governments to adopt the scheme and execute it this summer is seen as a huge challenge.

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