[et_pb_section fb_built=”1″ admin_label=”!!! PLEASE DO NOT EDIT !!!” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_row admin_label=”!!! PLEASE DO NOT EDIT !!!” _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.19.5″ _module_preset=”default” global_colors_info=”{}”][et_pb_text admin_label=”TO BE EDITED – SUMMARY – Click on the WHEEL icon to open the textarea where you can paste or type your summary. The summary condenses the main points for the news that starts below. The summary is in bold and not longer than 300 characters, including spaces. The counter at the bottom can help.” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||20px||false|false” global_colors_info=”{}”]<\/p>\n
India\u2019s flagship health insurance scheme, PM-JAY, is under strain as 650 Haryana hospitals suspend services over \u20b9490 crore unpaid dues, cutting off 18 million people. In J&K, limited hospitals and delayed payments worsen access gaps. Patients face debt, delays, and fragile health coverage.<\/strong><\/p>\n [\/et_pb_text][et_pb_text admin_label=”TO BE EDITED – TEXT OF THE NEWS – BLOCK 1 – Click on the WHEEL icon to open the textarea where you can paste or type your news. PLEASE USE ONLY THE FEATURED IMAGE FUNCTION on your right column to add the image.” _builder_version=”4.21.0″ _module_preset=”default” custom_padding=”||1em||false|false” global_colors_info=”{}”]<\/p>\n Earlier this month, 22-year-old Sunita faced a devastating reality when her father suffered a cardiac emergency. Expecting coverage under the government\u2019s Ayushman Bharat\u2013Pradhan Mantri Jan Arogya Yojana (PM-JAY), which promises up to \u20b95 lakh in hospital expenses per family, she was told that the private hospital in Haryana had stopped admitting scheme patients. The reason was months of unpaid dues from the government, part of a larger deadlock that has seen 650 private hospitals across Haryana suspend PM-JAY services. With nearly \u20b9490 crore pending for reimbursement, private hospitals argue that delays of six to nine months have made it impossible to cover costs for salaries, medicines, utilities, and daily operations. As a result, approximately 18 million poor residents in the state have been cut off from vital treatments offered in private facilities.<\/p>\n The suspension in Haryana highlights a deeper problem with the PM-JAY scheme nationally. Introduced in 2018 as the world\u2019s largest publicly funded health insurance programme for India\u2019s poorest 40% of households, it seeks to ensure cashless treatment in over 25,000 hospitals. Yet uneven implementation across states has exposed serious weaknesses \u2014 slow reimbursements, low package rates, reduced participation from private hospitals, and allegations of fraud. In Haryana, hospitals complain that government-set Health Benefit Package (HBP) rates fail to reflect rising medical costs, while authorities accuse hospitals of inflating bills and submitting questionable claims, thus justifying scrutiny and delays in payments.<\/p>\n For patients, however, the consequences are immediate and painful. Families like Sunita\u2019s, earning merely \u20b910,000 a month, are driven to debt as they seek treatment in under-equipped hospitals or turn to private care without scheme coverage. Public facilities meanwhile are overloaded with patients, leading to long waiting times and overstretched resources. In districts like Rohtak, patients requiring even routine surgery have been left waiting for months.<\/p>\n Elsewhere, particularly in Jammu and Kashmir, PM-JAY has struggled with different but related challenges. The region has fewer than 130 empanelled private hospitals, compared to Haryana\u2019s 650, leaving most of its population with limited choices. Providers are reluctant to participate, citing cumbersome empanelment procedures, low reimbursement rates, and delayed claim settlements that stretch beyond six months. Patients must often travel long distances, even across state borders, to receive eligible treatment, adding financial and physical burdens. For people like Naseema from Kupwara, diagnosed with breast cancer, these gaps mean draining savings simply to access surgery in far-off Srinagar.<\/p>\n Experts argue that these crises reflect the fragility of India\u2019s public-private healthcare partnership. The system hinges on timely government reimbursements, but when payments stall, private participation collapses. The Swiss Re Institute warns that India faces one of the world\u2019s largest \u201chealth protection gaps,\u201d with out-of-pocket spending still accounting for more than half of all medical expenses. Recent studies show that nearly 28\u201330% of Indian households face catastrophic health spending, far from the government\u2019s National Health Policy target to reduce this burden to 25% by 2025.<\/p>\n Although government health expenditure has risen modestly, reaching 1.84% of GDP in 2021\u201322, it remains insufficient to cover growing needs. The unfolding crises in Haryana and Jammu and Kashmir reveal how a scheme framed as a step toward universal health coverage risks becoming a patchwork safety net that fails during emergencies. For families like Sunita\u2019s, the gap between promise and delivery means falling into debt and uncertainty \u2014 leaving the central question unresolved: can PM-JAY truly protect India\u2019s poor, or will it remain a fragile lifeline?<\/p>\n [\/et_pb_text][et_pb_text admin_label=”TO BE EDITED – TEXT OF THE NEWS – BLOCK 2 – Click on the WHEEL icon to open the textarea where you can paste or type your news. PLEASE USE ONLY THE FEATURED IMAGE FUNCTION on your right column to add the image.” _builder_version=”4.21.0″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":" India\u2019s flagship health insurance scheme, PM-JAY, is under strain as 650 Haryana hospitals suspend services over \u20b9490 crore unpaid dues, cutting off 18 million people. In J&K, limited hospitals and delayed payments worsen access gaps. Patients face debt, delays, and fragile health coverage.Earlier this month, 22-year-old Sunita faced a devastating reality when her father suffered…<\/p>\n","protected":false},"author":2098,"featured_media":987782000,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":""},"categories":[],"tags":[122,134,135],"acf":[],"_links":{"self":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news\/987781997"}],"collection":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news"}],"about":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/types\/news"}],"author":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/users\/2098"}],"replies":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/comments?post=987781997"}],"version-history":[{"count":4,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news\/987781997\/revisions"}],"predecessor-version":[{"id":987782015,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news\/987781997\/revisions\/987782015"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/media\/987782000"}],"wp:attachment":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/media?parent=987781997"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/categories?post=987781997"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/tags?post=987781997"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}