Ayushman Bharat in Crisis: ₹1.21 Lakh Crore in Pending Dues Puts Healthcare at Risk

New Delhi/Shimla: A shocking RTI disclosure has exposed a severe financial crisis in Ayushman Bharat, the country's top healthcare scheme. As per the RTI report, an alarming ₹1.21 lakh crore worth of claims are pending payment, and more than 63 lakh cases are in the queue.

The delayed payments have put hospitals, particularly private hospitals, under great financial pressure, impacting their smooth functioning. The Right to Information (RTI) application, submitted by Ajay Basudev Bose on February 28, 2025, asked for information regarding the outstanding dues for hospitals registered under Ayushman Bharat. According to the official reply, 63,89,517 claims were outstanding, totaling a sum of ₹1,21,61,45,63,617.

Doctors raise concerns over healthcare collapse:

Dr. Lakshya Mittal, National President of the United Doctors Front (UDF), has strongly criticized the situation, calling it an alarming failure of the system.

He states that the, hospitals, in turn, would be left to suffer financially—if they do not get timely reimbursements. That would result in delayed salaries for healthcare workers, including doctors, nurses, and support staff. This will have a direct effect on the quality of care for patients, compelling hospitals to reduce crucial services.

Dr. Mittal further emphasized that the very intent behind Ayushman Bharat was to ensure smooth healthcare for the poor, but with such enormous unpaid bills, the intention of the scheme remains unmet. He urged that the government needs to take prompt action—clear these bills and ensure hospitals and health workers are not compelled to suffer the pangs of bureaucratic inefficiency.

Ayushman Bharat: Vision for Universal Health Coverage in India

Ayushman Bharat, India's most ambitious healthcare program, was rolled out as per the National Health Policy 2017 with a vision to reach the target of Universal Health Coverage (UHC). The game-changing program is in line with the Sustainable Development Goals (SDGs) and follows the principle of "leaving no one behind."

In contrast to the earlier disjointed healthcare schemes, Ayushman Bharat adopts a holistic, need-based strategy in the delivery of healthcare. It aims at reinforcing the entire system—from preventive care to promotive, primary, secondary, and tertiary care services—so that there is a smooth continuum of care. The initiative rests on two major components:

• Health and Wellness Centres (HWCs)

• Pradhan Mantri Jan Arogya Yojana (PM-JAY)

Dr. Munish Kumar Raizada, (MD, FAAP), President of Bharatiya Liberal Party, took to Twitter to quote, "Ayushman Bharat is on Ventilator. An RTI inquiry has revealed that arrears to the amount of ₹1.21 lakh crore are pending to be made to private hospitals, nursing homes and clinics. Sick systems of governance can hardly bring the relief, while governments continue to glorify their schemes."

Ayushman Bharat PM-JAY: The Largest Global Health Assurance Scheme

Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the world's biggest health assurance program, which provides ₹5 lakh per year for each family in case of secondary and tertiary hospitalization. It is covering financial protection for more than 12 crore poor families—nearly 55 crore people, which is India's bottom 40%.

Beneficiaries are chosen on the basis of deprivation and occupational criteria as defined in the 2011 Socio-Economic Caste Census (SECC) for rural and urban areas. This will make healthcare accessible to the most disadvantaged segments of society and ease the economic burden of medical costs on economically weaker households.^[1]

References:

1. National Health Authority. n.d. "Pradhan Mantri Jan Arogya Yojana (PM-JAY)." Government of India. Accessed February 2025. https://nha.gov.in/PM-JAY.

2. Himbu Mail. 2025. "₹1.21 Lakh Crore Ayushman Bharat Claims Processed." Himbu Mail. Accessed February 2025. https://himbumail.com/home/latest/rs-1-21-lakh-crore-ayushman-bharat-claims.

By Sai Sindhuja K

_MSM