One of the most ambitious health care reforms in history, Ayushman Bharat, was rolled out in 2018 in India. It is expected to provide health insurance coverage to 100 million below poverty line families in a country where two-thirds of all health expenditures are out of pocket, many households experience debilitating expenditures, and the incidence of chronic illnesses that require expensive care is increasing.
Will Modicare provide financial protection and improve health? Evidence from health insurance reforms in Ghana, China & Mexico suggests that the expansion of subsidized health insurance does not guarantee widespread coverage, access, or better outcomes.
On the other hand, proper insurance design and implementation can lead to success, as exemplified by the Vajpayee Arogyashree scheme in Karnataka which fully covered tertiary care services, improved the quality of care and reduced mortality from covered conditions by 64%.
Modicare incorporates several design features that have led to success in past insurance expansions, such as tertiary care coverage, working with the private sector, making enrollment easy, and expanding primary care access in rural areas. However, for the potential to be fully realized, it will be important to also focus on improving the quality of care.
Read more at Sood N, Wagner Z. India’s Historic Effort to Expand Health Insurance to Individuals Living Below the Poverty Line. JAMA Health Forum. Published online March 20, 2020. doi:10.1001/jamahealthforum.2020.0229
