According to sources from the Union Health Ministry, Odisha is in advanced talks with the National Health Authority (NHA) on integrating the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY) with its state health system. A family may receive up to Rs 5 lakh in annual health coverage through PMJAY for secondary and tertiary hospital care. Formerly called the Biju Swasthya Kalyan Yojana (BSKY), Odisha now manages its own healthcare program, the Gopabandhu Jan Arogya Yojana (GJAY). Families in rural Odisha can receive comparable health coverage through this state program.
At the moment, the integration effort is concentrated on fixing technical problems. Keeping the state scheme and PMJAY’s IT platforms synchronized is one of the major issues. Although PMJAY is dependent on Aadhaar, GJAY serves more than 90% of the people in Odisha without requiring Aadhaar connectivity. Beneficiaries will need to link their Aadhaar cards to the system in order to be in line with PMJAY. This will make the central government’s benefits available to qualified families under PMJAY.
With the exception of government employees and income taxpayers, Odisha’s GJAY offers rural families, for treatment in private institutions, health coverage of up to Rs 5 lakh. Through about 979 empanelled hospitals, the program currently serves about 47.9 million individuals, or 10.3 million families. In contrast, PMJAY serves fewer families in Odisha than the state’s healthcare program—roughly 7 million—based on the 2011 Socio-Economic Caste Census (SECC).
There will be financial ramifications to the combination of both plans. The federal and state governments will split the cost of supporting qualified families under PMJAY in a 60:40 funding ratio. The state will still be responsible for the financial burden for families covered by Odisha’s system but not eligible for PMJAY. Furthermore, after the first Rs 5 lakh cap is reached, women in Odisha are entitled to an additional Rs 5 lakh in health coverage, which the state will pay for.
Odisha would be the 34th state or union territory to adopt PMJAY after it joins, with West Bengal and Delhi being the only non-participants. A number of other states have already incorporated PMJAY into their state health schemes, including as Uttar Pradesh and Haryana. The goal of this integration is to save costs for both the federal and state governments while improving access to healthcare.
SOURCE :
BUSINESS STANDARD
