“Modicare is the world’s most comprehensive free medical insurance net and would prove to be the game changer for India,” Singh observed. The state government would appoint ‘Ayushman Mitra’ as facilitators/interface between the targeted beneficiaries and the designated hospitals and insurance companies. The insurance companies would be selected through the e-tendering.
The scheme would provide cover of up to Rs 500,000 per family per year and is aimed at benefitting over 100 million poor and vulnerable households comprising 500 million people. In April 2018, Modi had unveiled the maiden Health and Wellness Centre under Ayushman Bharat in Chhattisgarh on the occasion of Ambedkar Jayanti.
In Union Budget 2018-19, finance minister Arun Jaitley had announced the plan to provide free health insurance to about 107.4 million poor households. The scheme proposes to identify beneficiary households on the basis of the 2011 socio economic caste census. However, Jaitley had not specifically allocated funds for the scheme. Later, the Centre had clarified that the states would also need to contribute towards the ambitious programme.
Compared to Modicare, the United States’ Affordable Care Act (ACA), popularly termed as Obamacare and launched in 2010, had only targeted 50 million people. Thus, Modicare is 10 times the size of Obamacare. Modicare is estimated to incur about Rs 100 billon during 2018-19 and 2019-20 fiscals with the premium portion to be shared by the Centre and the state governments. The beneficiaries would be free to avail of benefits at the empaneled public and private hospitals.
The Centre would constitute Ayushman Bharat National Health Protection Mission Agency (AB-NHPMA), while the states and union territories are required to set-up a dedicated State Health Agency (SHA) for Modicare. In this regard, UP has already designated State Agency for Comprehensive Health and Integrated Services (SACHIS) for the purpose.