Tamil Nadu yet to implement expanded AB PM-JAY for people over 70 years

The expanded Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana (AB PM-JAY), meant for those aged 70 and above, has not yet been implemented in Tamil Nadu, though nearly one year has passed since the scheme’s launch.

As of now, differences of opinion between the Union government and the Tamil Nadu government with regard to the implementation have not been resolved. “We have had a few rounds of discussion with the Centre,” says a senior official here, adding that the State government is awaiting clarification from the Central government. S.K. Mahendran, former MLA and president of the Madras Labour Union, in a statement, mentions that after having contacted the authorities concerned including those in the National Health Authority (NHA), it has become clear the scheme is “only on paper.”

On October 29 last year, the Union government expanded the scope of the AB PM-JAY to provide free treatment benefits of up to ₹5 lakh per year to all senior citizens aged 70 and above along with their families, irrespective of their socio-economic status. As per an official estimate, 6 crore senior citizens concerned, representing 4.5 crore families, get covered under the scheme. This number has been arrived at, keeping in mind the 2011 Census and extrapolating the number of such senior citizens with an annual growth rate of 3.73%.

In Tamil Nadu, approximately 43.19 lakh such persons, belonging to 32.35 lakh families, stand to benefit. A document of the NHA states that 4.06 lakh individuals from 3.69 lakh families figure in the PM-JAY database. The estimated figures of new beneficiaries and their families are around 39.13 lakh persons from 28.66 lakh families.  (According to the Election Commission’s data at the time of 2024 Lok Sabha poll, the persons aged 70 and above accounted for about 53.12 lakh). The ratio of contribution towards premium between the Centre and States is 60:40, except in northeastern States and three States in the Himalayan region, where the former takes the burden up to 90%.  As of now, the Union government bears ₹1,000 crore annually and the State, ₹200 crore, the official says.

Inaugurated in September 2018, the AB PM-JAY had originally sought to provide  secondary and tertiary care hospitalisation, through empanelled hospitals, to 12 crore families constituting “economically vulnerable bottom 40%” of the country’s population.  As for the differences between the Centre and the State, the official explains that they have cropped up in respect of the original version of the scheme over the definition of “economically vulnerable bottom” of the people.

While the Centre has relied on the findings of the Socio-Economic Caste Census (SECC) of 2011, the State government takes the annual income of ₹1.2 lakh per family as the basis for determination of poverty. Consequently, the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) benefits 1.48 crore families, of which 86.5 lakh families are covered under the integrated CMCHIS-PM-JAY. The former absorbs 60% of the premium (which is ₹869 per family) only in respect of the latter.

“Our point is that the Centre, which waives the economic criterion for those beneficiaries aged 70 and above, should accept our estimate of the economically vulnerable people. We want them to bear 60% share of the premium for these people, numbering around 60 lakh,” the official adds.