Healthcare, Citizenship and Social Inclusion - A Sociological Analysis of Ayushman Bharat (PM-JAY)

Abstract

When Ayushman Bharat was launched in 2018, it was described as the world’s largest government-funded health insurance programme. That description is factually accurate. The Pradhan Mantri Jan Arogya Yojana (PM-JAY) component covers over 12 crore households, offers cashless hospitalisation cover of up to ₹5 lakh per family per year, and has — according to the National Health Authority dashboard — already authorised over 6.8 crore hospital admissions and over ₹85,000 crore in claims. This paper tries to look at what all of this has actually meant for social inclusion in India. Drawing on NHA dashboards, PM-JAY annual reports, MoHFW policy documents and a range of sociological research, it attempts to go beyond the numbers to ask: who is genuinely benefiting, and who is still being left out? The findings are, as one might expect, mixed. The scheme has done really good. It has also reproduced some old inequalities in new forms, particularly around urban-rural hospital clustering, biometric authentication failures at kiosks, and the very real difficulty that many rural women face in physically accessing empanelled hospitals even when they hold a valid card. The paper closes with some practical policy suggestions.