A Critical Evaluation of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana in Bihar

Authors

Pratyasha Tripathi

Tilka Manjhi Bhagalpur University, Bhagalpur, Bihar (India)

Article Information

DOI: 10.51244/IJRSI.2025.120800064

Subject Category: Public Health

Volume/Issue: 12/8 | Page No: 776-786

Publication Timeline

Submitted: 2025-08-05

Accepted: 2025-08-12

Published: 2025-09-04

Abstract

Ayushman Bharat, by Lahariya, 2018, Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), launched in 2018, is India’s flagship health insurance scheme aimed at improving access to healthcare while protecting vulnerable families from financial distress due to medical expenses. This study takes a closer look at how the scheme is performing in Bihar—a state grappling with both economic and healthcare delivery challenges.
Drawing on NFHS-5, by International Institute for Population Sciences (IIPS) & ICF, 2021, (2019–21), NSSO, Government of India, 2019, 75th round (2017–18), and primary data from 336 AB-PMJAY beneficiaries admitted to a tertiary hospital, the study explores changes in insurance awareness, healthcare usage, and out-of-pocket expenditure. Results show that average OOPE dropped from 76.1% to 30% of a family's monthly expenditure after admission under the scheme. Catastrophic health spending also fell sharply, from 65.5% to around 29%.
While there has been visible progress in insurance coverage and financial risk protection, shown by Prinja et al., 2019, the benefits are not yet evenly distributed. Rural households, women, and marginalized communities still face gaps in awareness and access. The findings suggest that while AB-PMJAY has made a positive impact, more targeted efforts are needed to ensure its reach and effectiveness for every citizen

Keywords

Ayushman Bharat, ABPMJAY, Bihar, health insurance, financial protection, healthcare utilization, out-of-pocket expenditure, NFHS-5, NSSO.

Downloads

References

1. Government of India. (2019). National Sample Survey 75th Round: Health in India 2017–18. Ministry of Statistics and Programme Implementation, National Statistical Office. https://www.mospi.gov.in [Google Scholar] [Crossref]

2. International Institute for Population Sciences (IIPS) & ICF. (2021). National Family Health Survey (NFHS-5), 2019–21: Bihar State Report. Mumbai: IIPS. [Google Scholar] [Crossref]

3. Kanwal, S., Kumar, D., Chauhan, R., & Raina, S. K. (2024). Measuring the effect of Ayushman Bharat–Pradhan Mantri Jan Aarogya Yojna (AB-PMJAY) on health expenditure among poor admitted in a tertiary care hospital in the northern state of India. Indian Journal of Community Medicine, 49(2), 342–348. https://doi.org/10.4103/ijcm.ijcm_713_22 [Google Scholar] [Crossref]

4. Lahariya, C. (2018). 'Ayushman Bharat' program and universal health coverage in India. Indian Pediatrics, 55(6), 495–506. [Google Scholar] [Crossref]

5. Lahariya, C. (2021). Taking the road less traveled: Economic analyses for advancing universal health coverage. Journal of Postgraduate Medicine, 64(3), 134–135. [Google Scholar] [Crossref]

6. Prinja, S., Bahuguna, P., Gupta, I., Chowdhury, S., & Trivedi, M. (2019). Role of insurance in determining utilization of healthcare and financial risk protection in India. PLOS ONE, 14(2), e0211793. https://doi.org/10.1371/journal.pone.0211793 [Google Scholar] [Crossref]

7. Singh, P., & Kumar, V. (2017). Insurance coverage under different health schemes in Uttar Pradesh, India. Clinical Epidemiology and Global Health, 5(1), 33–39. [Google Scholar] [Crossref]

8. Thakur, H. (2016). Study of awareness, enrollment, and utilization of Rashtriya Swasthya Bima Yojana in Maharashtra, India. Frontiers in Public Health, 3, 282. https://doi.org/10.3389/fpubh.2015.00282 [Google Scholar] [Crossref]

9. Angell, B. J., Prinja, S., Gupt, A., Jha, V., & Jan, S. (2019). The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana and the path to universal health coverage in India: Overcoming the challenges of stewardship and governance. PLOS Medicine, 16(3), e1002759. https://doi.org/10.1371/journal.pmed.1002759 [Google Scholar] [Crossref]

Metrics

Views & Downloads

Similar Articles