AB-PMJAY currently excludes prosthetic and orthotic treatments

AB-PMJAY has improved healthcare access for vulnerable groups, but currently excludes prosthetic and orthotic treatments, leaving millions of disabled Indians without essential mobility and rehabilitation support. The 2023-24 Annual Report from the Department of Empowerment of Persons with Disabilities estimates 2.68 crore (26.8 million) people with disabilities in India, about 2.21% of the population. Locomotor disabilities are the largest group, making up around 44.7% of all disabilities, according to recent NFHS-5 data and studies. This is a sharp rise from the 2018 NSSO survey’s figure of 61 lakh, highlighting the urgent need for better access to assistive devices and inclusive healthcare.

Markanda Chandra Das, President, Orthotics and Prosthetics Association of India (OPAI) said, “Restoring mobility is a fundamental right tied to an individual’s dignity, productivity, and future. The reform we advocate will allow India’s PwDs to participate fully in education, work, and society, strengthening the very spirit of Viksit Bharat 2047 and the Accessible India Campaign. Inclusion of advanced prosthetic and orthotic care under AB-PMJAY will help fulfil both the Rights of Persons with Disabilities Act and India’s commitment to the UN Convention on the Rights of Persons with Disabilities.”

The petition, submitted by the OPAI and a representative amputee group of 12, highlights proven state-level models, such as Tamil Nadu’s Chief Minister’s Comprehensive Health Insurance Scheme, which has successfully provided advanced prosthetics to over 1,000 beneficiaries for several years. Global research demonstrates that every Re 1 invested in assistive technology returns up to Rs 9 in productivity and economic empowerment. Yet, only 23% of PwDs in India are currently employed, compared to 47% of the general population.

The campaign will use the upcoming World Para Athletics Championships 2025 as a public platform, inviting signatories nationwide to join this appeal ahead of the petition’s planned submission to the Prime Minister.

Key Demands of the Petition:

Inclusion of P&O Devices: Add prosthetic limbs, orthotic braces, spinal and foot supports, and wheelchairs (as listed in the National List of Essential Assistive Devices) under AB-PMJAY.

Dedicated Rehabilitation Packages: Create a sub-package covering rehabilitation and post-operative care for amputees and persons with locomotor disabilities.

Empanelment of Accredited P&O Centres: Standardise service delivery through pre-approved P&O providers for assessment, fitting, and follow-up.

Seamless Integration: Enable P&O centres to work in partnership with AB-PMJAY-empanelled hospitals to ensure smooth delivery and comprehensive care.

This OPAI-led initiative echoes India’s commitments to the Sustainable Development Goals, especially “Good Health and Well-Being” (SDG 3) and “Reduced Inequalities” (SDG 10), and seeks to initiate a novel policy shift for millions of Indians awaiting the right to dignity and mobility. For more information about the campaign, participation, or to register support, please visit OPAI’s official website.

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Even though the scheme was a policy decision by the government, the Prime Minister took a dig at two opposition-ruled states, West Bengal and Delhi, as they decided to opt out of the scheme. These two states will not roll out this extension of AB PM-JAY. However, analysis done by a daily newspaper The Indian Express shows that about 45% of hospitalisations carried out under the scheme were from opposition-ruled states: Tamil Nadu, Karnataka, Kerala, Punjab, Jharkhand, Himachal Pradesh, and Telangana.

“I apologise to the people over 70 years from Delhi and West Bengal that I will not be able to serve you. I apologise because- I will come to you know that you are suffering. I will get the information, but I will not be able to help you. The reason is that the Delhi and West Bengal governments are not joining the Ayushman Bharat scheme. I’m prevented from serving older people of Delhi and West Bengal. Because of politics. I am painted”, said the prime minister.

What is the Scheme About?

While addressing an event at ‘Ayurveda Day’ in Delhi, the prime minister of India launched the senior citizen extension to the AB PM-JAY scheme. The extension aims to significantly reduce out-of-pocket expenses for low-income households. This extension of AB PM-JAY, only for senior citizens, will open the door to essential medical treatment and emergency care that were earlier unfordable. Earlier AB PM-JAY was income-based, providing Rs.5 Lakh to all eligible families. But under the expanded scheme, all 70+ will get an additional top-up cover of Rs. 5 lakh per year for themselves. Politically too, the impact of this extension will be visible more in the marginalised sections and therefore will garner trust for the Modi government.

Health is a primary union government subject and therefore this scheme is an important decision by the Modi government. As per the expanded scheme, all eligible beneficiaries will be issued an Ayushmann Vaya Vandana card. Simultaneously, a separate portal to register the elderly will be functional by Tuesday. Now, all beneficiaries can register at the nearest Ayushmann Kendra or can even do the process online via the Ayushmann NHA app.

Other than the expansion of the health scheme, the Prime Minister also launched the U-WIN portal. The portal will digitally manage vaccination, tracking two vaccines for pregnant women and 11 vaccines for children.

The Scheme in Different States

Data from the Union Health Ministry on funds spent on the health scheme by different states highlight how required financial relief was provided to families who could otherwise not afford any specialised treatment. For example, in Tamil Nadu, the funds were diverted towards general surgery, paediatric medicine and general medicine. In the state of Karnataka, the majority of the same funds were used in cardiology, cardio and vascular surgery and neurosurgery. While in the northern states of Punjab, funds were diverted mostly towards orthopaedics, general surgery and cardiology. The state of Jharkhand concentrated its funds towards ophthalmology, general surgery and general medicine.

The funds used by the scheme vary as per different states. This is because there is a highly differential healthcare need across all the states of India and the scheme is flexible to adjust.

However, in West Bengal, the already rolled out ‘Swastha Saathi’ state health scheme makes the Centre’s AB PM-JAY an unnecessary policy intervention. This state scheme gives Rs. 5 Lakh health insurance cover a year and has currently enrolled approximately 2.4. crore families. For this reason, the state has decided to push itself out of the AB PM-JAY. However, it could not do that peacefully without achieving backlash from the Prime Minister of the country.

The AB PM-JAY is an important scheme beyond political battles and electoral lip service. It is a mega health scheme in India that has the potential to create a difference. Alongside, it also aims to make healthcare more affordable, which currently cannot be taken up by the poor.

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The ground-plus-six floor residential complex has 24 fully-furnished quarters, which ensures round the clock availabilities of Doctors for attending to all kind of emergencies.

To address the healthcare needs of the local people of Sivasagar, ONGC decided to set up a multi-specialty hospital in the region, which was long deprived of quality healthcare facilities. ONGC Board accorded approval for setting up a 300-bed multi-specialty hospital in three phases through ONGC Foundation. Dr. Babasaheb Ambedkar Vaidyakiya Pratishthan has been engaged as the construction management and operating partner.

The services of the first phase of the hospital, with 67 beds, were inaugurated by Petroleum Minister Dharmendra Pradhan on 1 March 2019 at Guwahati. In one year, over 33000 people have already been benefitted from the healthcare facility, out of which 6800 were dialysis patient. Phase II of the project is in advance stage of completion and scheduled to be commissioned by Sept 2021. The three new blocks coming up as part of Phase II will accommodate 162 additional beds with all allied services.

The ONGC CSR project has helped the local people, who had to earlier travel over 90 Km to Dibrugarh to receive even basic medical attention. The hospital is empaneled with Ayushman Bharat and Atal Amrit scheme of Govt. which has facilitated in providing treatment to all sections of society.

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The Indian government has envisioned NDHM as a digital health ecosystem that will encompass health identification, a health facility registry, individual health records and a pan India Digi Doctor network. Doctors can register themselves and provide contact details to Digi Doctor expressing their availability for services. They will get digital signatures for signing prescriptions.

Telemedicine and e-pharmacies are planned later on, with guidelines with framed at the moment. The Ministry of Health and Family Welfare (MoHFW) will oversee the National Digital Health Mission, with the National Health Authority (NHA) being the implementing agency. An app and a website are the immediate manifestations of the scheme.

Every citizen is expected to sign up online for a Health ID with a number that is uniquely assigned to him/ her. The Health ID is voluntary for all Indian citizens. This will be linked to personal health records, contact number and health data consent manager. The purpose of the consent manager is to ensure seamless flow of information from the records.

NDHM is a byproduct of the National Health Policy 2017. The goal of the ecosystem is to serve the needs of all stakeholders and improve linkages across healthcare providers. NHP 2017 proposes free drugs, diagnostics and emergency. Access and financial protection of patients in all public hospitals will be the end result. It’s an important step towards a comprehensive primary healthcare package. Although coronavirus disease has taken over the collective consciousness, there are major non-communicable diseases to consider apart from senior health, mental health and rehabilitative care services. This is where a system like NDHM will prove useful.

The policy is not ironclad, however. It does not consider ‘Health’ to be a right. There should be a push to making health a justiciable right. Data security of citizens is another concern. How safe is the health and personal information of patients from being sold or hacked and misused for profit?

The National Health Service (NHS) in the UK has failed before and during the pandemic. What lessons can the NHS in India learn and incorporate into the NDHM before launching the mission? Although National Digital Health Mission is a central government scheme, it needs to align with state-specific healthcare schemes and other government programmes like Ayushman Bharat and NIKSHAY. There’s a long way to go before we can celebrate the achievement of universal healthcare.

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For a country where about 70.6 million people are unable to make ends meet, expecting them to consider having health insurance is a stretch.

In order to protect this vulnerable population during health emergencies, the Government of India has introduced various healthcare insurance schemes that are affordable to everyone and provides basic health coverage to all.

1. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana Aka Modicare

This scheme was launched in September 2018 by Prime Minister Narendra Modi in Ranchi Jharkhand. This world’s largest government-funded healthcare scheme is aimed at securing poor, deprived rural families and identified occupational category of urban workers’ families. The scheme will provide coverage of up to Rs. 5 lakhs per year for each eligible family for tertiary and secondary care hospitalization. This scheme will be available in public hospitals as well as chosen private hospitals with no cap on the family size. This scheme will subsume the existing Rashtriya Swasthiya Bima Yojana.

2. Central Government Health Scheme (CGHS)

This insurance policy of the Government of India offers comprehensive medical facilities to the employees of Central Government, the pensioners, and their dependents. There are CGHS dispensaries for beneficiaries in many cities of the country who can choose to take Allopathic, Homeopathic, Yoga, Ayurveda, Siddha, and Unani system medical treatments.

3. Employment State Insurance Scheme (ESIS)

This scheme is basically a system to provide multi-dimensional healthcare security to the worker population of India and their families. Generally, a factory or an organization with an employee strength of 10 or more can opt for this scheme for its employees. The employer pays 4.75%, whereas the employee pays 1.75% of the wages earned by an employee who is earning not more than Rs. 21,000/- every month. Under the scheme, the insured is entitled to not only complete medical care but also financial advantages in case of earning capability loss.

4. Universal Health Insurance Scheme (UHIS)

UHIS is a joint venture of four general insurance companies of the private sector to provide healthcare facilities to families living below the poverty line. Under this scheme, the insured is reimbursed with Rs. 30,000 against medical expenses caused due to hospitalization. Death of the earning member of the family due to an accident is covered in this scheme, under which the family is given Rs.25, 000/- as compensation.

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