NITI Aayog Releases Report on ‘Health Insurance for India’s Missing Middle’

What is the News?

Niti Aayog has released a report titled ‘Health Insurance for India’s Missing Middle’.

What are the key Findings of the report?

At least 30% of the population, or 40 crore individuals – called the missing middle are devoid of any financial protection for health:

• The Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana(AB-PMJAY) and State Government schemes provide comprehensive hospitalization cover to the bottom 50% of the population. 
• Another 20% of the population are covered through social health insurance and private voluntary health insurance. 
• But the remaining 30% of the population or 40 crore individuals are without any health insurance. This uncovered population is termed as the missing middle. 
• Missing middle predominantly constitutes the self-employed (agriculture and non-agriculture), the informal sector in rural areas and a broad array of occupations – informal, semi-formal, and formal – in urban areas.

What should be done to cover the missing middle?

The report has recommended three models.

First Model: It focuses on increasing consumer awareness of health insurance.

Second Model: It is about developing a modified, standardized health insurance product like ‘Arogya Sanjeevani’. It is a standardised health insurance product launched by the Insurance Regulatory Development Authority of India, IRDAI) in 2020.

Third Model: This model recommends the expansion of PMJAY to a wider set of beneficiaries. This is the only model out of three proposed which has fiscal implications for the Government. 

What are the other Suggestions in the Report?

The report has suggested sharing of the government scheme data with the private insurance companies. 

Government databases such as National Food Security Act (NFSA), Pradhan Mantri Suraksha Bima Yojana or the Pradhan Mantri Kisan Samman Nidhi (PM-KISAN) for agricultural households can be shared with private insurers after taking consent from these households.

Such databases will help ease the identification of and outreach to potential customers by insurers.

Source: This post is based on the following articles:

• “NITI Aayog Releases Report on ‘Health Insurance for India’s Missing Middle” published in PIB on 30th October 2021
• “At least 40 cr individuals don’t have any financial protection for health: Niti Aayog” published in Financial Express on 30th October 2021.