Odisha is in discussions with the National Health Authority (NHA) to join the Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (PMJAY), sources in the health ministry have confirmed.
The PMJAY aims to provide health cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation.
Official sources say that discussions with the state are at an advanced stage, with the state almost ready to join the scheme. “Odisha is already implementing its own health scheme, which will now run alongside this central scheme, and some technical issues are being worked out,” sources added.
The technical modalities being discussed include integrating the state scheme’s IT platform with PMJAY and regularising beneficiary lists.
“While PMJAY is an Aadhaar-based scheme, Odisha’s state scheme covers over 90 per cent of its population and is not based on Aadhaar. They will have to link it to the Aadhaar card so that beneficiaries eligible under PMJAY can get benefits,” a senior official said.
Queries mailed to the Odisha Health Department and NHA did not elicit any response immediately. The story will be updated with responses as they arrive.
Odisha’s Gobandhu Jan Arogya Yojana (GJAY), earlier known as Biju Swasthya Kalyan Yojana (BSKY), provides Rs 5 lakh health coverage in private hospitals to all rural families, except government employees and income taxpayers in the state.
This takes the number of eligible beneficiaries to nearly 1.03 crore families, reaching 4.79 crore individuals through 979 private empanelled hospitals in and outside the state, according to data available on the BSKY dashboard.
Since the AB-PMJAY covers beneficiaries based on deprivation and occupational criteria of the Socio-Economic Caste Census (SECC) 2011, close to 70 lakh families in Odisha are eligible for it. This is far fewer than the number of beneficiaries covered under the state scheme.
The scheme also provides an additional Rs 5 lakh coverage for the women members of the family after exhaustion of the initial limit.
After the scheme integration, the Centre will share the financial burden for families eligible for PMJAY under the 60:40 framework decided for it.
“For those not eligible under the central scheme, the state will fund from its budget. Since women members are covered for an additional Rs 5 lakh in Odisha, the extra coverage for them will be borne by the state,” the source added.
With Odisha joining the AB-PMJAY, 34 states and union territories (UTs) would have implemented the scheme, with West Bengal and Delhi remaining as the only holdouts.
Currently, 18 states have converged their state-specific schemes with PMJAY, of which four—namely Uttar Pradesh, Haryana, Uttarakhand, and Nagaland—run their state employee schemes in convergence with PMJAY hospitals and IT platform.
The NHA is also in the process of integrating Karnataka’s Karnataka Arogya Sanjeevani Scheme into its IT platform.
First Published: Sep 24 2024 | 6:20 PM IST
