Aadhaar Makes Ayushman Bharat Less Inclusive, May Not Cover All Beneficiaries

Ayushman Bharat – National Health Protection Scheme (AB-NHPS), a centrally funded scheme intended to cover 50 crore Indians with health insurance, may not cover all beneficiaries if they do not have Aadhaar number. The tender documents issued by the Centre for enrollment of insurance companies providing cover states that beneficiaries may avail the facility only once – if they do not have the Aadhaar number. They will be directed to nearest Aadhaar Centre for enrolment to avail benefits for their next treatment. 

The revelation comes in the wake of latest Supreme Court order which had prohibited the Centre from making Aadhaar mandatory for availing the benefits of the government schemes. The documents are unclear about whether any alternate mechanism will be devised to include people without Aadhaar number. A study of the documents shows the entire scheme is centred on Aadhaar. This can be gauged from the lines which mandate that a beneficiary must produce Aadhaar for their second treatment. “A signed declaration is taken from the Beneficiary that he does not possess an Aadhaar card and understands he will need to produce an Aadhaar or an Aadhaar enrolment slip prior to the next treatment,” read the document.

The scheme also mandates hospitals providing healthcare to engage ‘Ayushmaan Mitra’, who will run help desks, check documents and advise people on eligibility and enrollment to the scheme. They will also be tasked with advising people to get themselves enrolled at nearest Aadhaar centres. “If Aadhaar card/number is not available then beneficiary will be advised to get the Aadhaar card/number within stipulated time,” the document further added. 

The scheme also mandates that if a family member wishes to be included in the scheme, then a family member needs to verify the credentials and the verification can only be validated through Aadhaar number only. It also makes it mandatory for states to complete the formalities if they wish to get more residents covered in the previous list of beneficiaries. While the most states have signed memoranda of understanding (MoUs) with the Centre, the Odisha government has refused to implement the scheme. It said that state governments are being forced to fulfil its guidelines. The state government wanted 70 lakh families to be covered, the Centre reportedly allowed for inclusion of 61 lakh families. 

The scheme has also drawn ire from the Indian Medical Association, and it has called for its review for the conceptual deficits and operational flaws of the scheme. The body said the rates quoted by government for surgeries expose patients to danger, and do not cover 30 per cent of the procedures. 

“No hospital can work on these rates without seriously compromising patient safety. In the garb of cost-cutting, the government is exposing the people to danger in the hospitals. “Caesarean sections underwritten for ₹9,000 cannot ensure safety of the mother and the child,” IMA national president Dr. Ravi Wankhedkar said.

“The highly optic NHPS fails to create any new national asset. The same money invested in our public hospitals would have brought secondary and tertiary care closer to poor in our government hospitals,” he said.

“In addition to non-creation of new public sector hospitals, the government will lose around ₹400 crore to private health insurance companies which will manage the scheme. The insurance driven healthcare is a failed experiment,” added Wankhedkar.