Very recently, in March 2018, the Union Cabinet chaired by the Prime Minister has approved the launch of a new Centrally Sponsored Ayushman Bharat-National Health Protection Mission (AB-NHPM), which was announced in the Budget. This scheme is claimed to be the world's largest government funded health care programme. The central sector component under Ayushman Bharat Mission will be anchored in the Ministry of Health and Family Welfare (MoHFW). AB-NHPM will subsume the on-going centrally sponsored schemes – Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
This scheme will provide benefit cover of Rs. 5 Lakh per family per year. The target beneficiaries of the proposed scheme will be more than 10 crore families belonging to poor and vulnerable population based on the latest SECC (Socio-Economic and Caste Census) data, covering both rural and urban. To ensure that nobody is left out (especially women, children and elderly), there will be no cap on family size and age. The scheme is designed to be dynamic and aspirational and it would take into account any future changes in the exclusion/ inclusion/ deprivation/ occupational criteria in the SECC data.
The benefit cover will take care of almost all secondary care and most of tertiary care procedures. It will include pre and post-hospitalisation expenses. All pre-existing conditions will be covered from the beginning. The benefits of the scheme are portable across the country and a beneficiary will be allowed to take cashless benefits from any public/private empanelled hospitals. A defined transport allowance per hospitalization will also be paid to the beneficiary. Central Govt. will provide payment for treatment on ‘Package Rate Basis’. The package rates will include all the costs associated with treatment. In partnership with NITI Aayog, a robust, modular, scalable and inter-operable IT Platform will be made operational which will entail a paperless and cashless transaction. This would also help in prevention / detection of any potential misuse / fraud / abuse cases.
One of the core principles of AB-NHPM is Co-operative federalism and Flexibility to states. There is provision to partner the States through co-alliance. State Governments will be allowed to expand AB-NHPM both horizontally and vertically. States will be free to choose the modalities for implementation. They can implement through Insurance Company or directly through Trust/ Society or a mixed model. AB-NHPM will be rolled out across all States/UTs in all districts with an objective to cover all the targeted beneficiaries with improved efficiency, reach and coverage.