Ayushman Bharat and Covid-19

August 01, 2021

Image source: https://rb.gy/wishkg

This article has been written by Adarsh Vasudeva, pursuing the Certificate Course in Advanced Civil Litigation from LawSikho.


Ayushman Bharat is a flagship scheme of the Indian government aimed at achieving the vision of Universal Health Coverage (UHC). The aim of this effort is to achieve the Sustainable Development Goals (SDGs) and the underpinning promise to “leave no one behind.” Ayushman Bharat is an effort to transition from a sectoral and segmented approach to a comprehensive, need-based health care system. This program seeks to implement ground-breaking approaches at the primary, secondary, and tertiary levels to approach the healthcare system holistically (including prevention, promotion, and ambulatory care). Ayushman Bharat being the largest health insurance scheme has a vital role to play during Covid-19 and therefore this article analyses the effectiveness of the Ayushman Bharat scheme pre and post Covid-19. This article also covers key features, budget and coverage of the Ayushman Bharat policy.

Policy key features

Ayushman Bharat was initiated with the aim of establishing 1,50,000 “health and wellness centres” in the country and providing health insurance coverage of INR 5 lakh to 10 crore families (50 crore people). This policy has two components:

  1. Health and Wellness Centers will offer Comprehensive Primary Health Care (CPHC), which will provide free essential medications and diagnostic facilities for both mothers and children.
  2. Pradhan Mantri Jan Arogya Yojana (PMJAY) – To deliver health protection of INR 500,000 per family per year (on a family floater basis) for secondary and tertiary care hospitalization through public and private empanelled hospitals in India, to poor and needy families against financial danger resulting from devastating health episodes.

Roll out/ Implementation

The aim of Ayushman Bharat of covering PAN India is fragmented as the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana is not being enforced in the National Capital Territory (NCT) of Delhi, Odisha, Telangana, or the West Bengal States as of 10.03.2021. The Government of the National Capital Territory of Delhi declared during the 2020 budget session that AB-PMJAY will be introduced in the State, but no further action has been taken. The AB-PMJAY scheme was introduced in West Bengal from September 23, 2018, to January 10, 2019, with a central share of Rs. 31.28 crore released to cover scheme-related expenses. On the 10th of January 2019, however, the state government agreed to stop implementing the program. In the cases of Odisha and Telangana, ongoing consultations with the respective state governments are underway to persuade them to introduce the AB-PMJAY.  Rest all other states have implemented the aforesaid scheme. Irrespective of the fact that public health is a state responsibility and the State government in charge of implementing AB-PMJAY has the final say, the vision of this scheme is incomplete without implementing it in the national capital itself, including other major states.


Role and implementation of Ayushman Bharat amid Covid-19

However, in order to make use of the Ayushman Bharat scheme’s benefits, a person must be hospitalised in a hospital for at least one day. If you test positive for Covid-19, you can only use the programme until you are admitted to a hospital. With the condition of being eligible for Ayushman Bharat Yojana, a person can receive treatment for Covid-19 at private facilities affiliated with the scheme.

Utilization of Ayushman Bharat scheme for Covid-19


Budget of Ayushman Bharat Amid Covid-19

The Government of India’s health insurance allocations has improved substantially since the start of PMJAY. Allocations in the Revised Estimate (RE) were 2,400 crores when PMJAY was launched in FY 2018-19 and raised to 6,400 crores in FY 20 Budget Estimates (BEs), which were the same as Interim Budget allocations. However, there is no raise in funding for the central government’s flagship programme, Pradhan Mantri Jan Arogya Yojana— Ayushman Bharat (PMJAY-AB) for the fiscal year 2020-21. It was Rs 6,400 crore in 2019-20, and it will be the same in 2020-21. COVID-19 has impacted those who have the least access to health services, so the health scheme, which mostly focuses on underprivileged society, should have received more attention before allocating the budget. The INR 6400 crore budgeted for the scheme is insufficient to cover the target population. Even if the beneficiaries spend only 1% of their INR 5 lakh quota in a year, the annual spending will be about INR 50,000 Cr, which is much more than the government’s current estimate and allotment. 

Shortage of funds amid Covid-19

Funds Data of AB-PMJAY since the inception of the scheme as on 21.09.2020


Budget Amount            (Amount in Crores)

Disbursed Amount          (Amount in Crores)


















Ref: Lok Sabha unstarred question no. 2122 answered on 23rd September 2020.

The above table compares the budgeted amount and disbursed amount for Ayushman Bharat -Pradhan Mantri Jan Arogya Yojana (AB PMJAY) and observes the following points:

According to the aforementioned data, Ayushman Bharat, which was designed particularly for the poor, should have got 100% of the budget allotted. Health flagship programmes should be on their toes at a time when COVID is taking away millions of jobs and lives.  But we should also look at the other side of the coin which shows that following the announcement of the first nationwide lockdown on March 23, 2020, ABPMJAY saw a 50% decline in utilisation. 

Major State-wise fund allocation in the time of Covid-19

Major States\ Funds (Crores)

Allocation in 2018-19

Allocation in 2019-20

Allocation in 2020-21

% Change during Covid-19



























Madhya Pradesh










Uttar Pradesh





The table shows an allocation of Ayushman Bharat funds to major states.



As every scheme has the scope of improvement, constant development even in this scheme will help it to achieve its objective. The scheme is somehow underfunded and is impossible to function with 100% compliance. A policy brief paper published by the National Health Authority (NHA), the apex body in charge of implementing Ayushman Bharat, exposes flaws in budget use, especially in poor states. To understand the demand and supply-side concerns that must be addressed, it will be necessary to perform deep dives at the state level through conversations and beneficiary and provider surveys. Based on state-specific studies, guidelines, and inputs, many state health authorities are beginning to perform deeper investigations to examine the feasibility and suitability of these changes for the local environment. In order to guarantee that poor and disadvantaged people have access to vital healthcare, it is critical to harness the ever-growing potential of the private healthcare sector, as well as dramatically improve the infrastructure and quality of care offered in public hospitals. Monitoring the quality and appropriateness of care, as well as having a clear set of standards for hospitals to make their employees and beneficiaries aware of the preventative measures and protect their safety during this epidemic, are also crucial.

During COVID19, AB PMJAY plays a key role in delivering healthcare to impoverished and vulnerable people. All efforts must be ramped up to guarantee that all essential and non-essential hospitalisation treatment is supplied through public and private empanelled hospitals under the AB PMJAY programme, in conjunction with primary care supplied through the public health infrastructure.


  1. https://pmjay.gov.in/sites/default/files/2020-10/Assessing_Impact_of_COVID-19_on_PMJAY.pdf.
  2. https://www.thehindu.com/news/national/coronavirus-can-private-hospitals-charge-covid-19-patients-at-ayushman-bharat-rate-asks-supreme-court/article31757698.ece.
  3. https://qz.com/india/1865845/ayushman-bharat-has-a-role-to-play-in-indias-covid-19-response/.
  4. https://krishijagran.com/news/covid-19-positive-heres-how-ayushman-bharat-yojana-will-help-you-get-free-treatment/.
  5. https://www.livemint.com/news/india/covid-19-is-now-covered-under-ayushman-bharat-scheme-death-toll-86-so-far-11586001274077.html.

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