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ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue X October 2025
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A Study on Socio-Economic Impact of PM-JAY Health Insurance
Scheme on Indian Households
Dr. C. Pushpalatha
1
, R. R. Raghavi
2
*
1
Associate Professor in Commerce, Sri G.V.G. Visalakshi College for Women, Udumalpet
2
Research Scholar in Commerce, Sri G.V.G. Visalakshi College for Women, Udumalpet
*Corresponding Author
DOI: https://dx.doi.org/10.51244/IJRSI.2025.1210000158
Received: 30 October 2025; Accepted: 05 November 2025; Published: 11 November 2025
ABSTRACT
Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme was launched on September
23,2018 by the government of India. This study explores the socio-economic impact of the PM-JAY scheme on
Indian households, emphasizing its effectiveness in reducing out-of-pocket (OOP) healthcare expenditures,
enhancing access to medical services, and strengthening overall financial protection. Additionally, it evaluates
the scheme’s coverage across different Indian states by analysing state-wise enrolment patterns and beneficiary
penetration levels. The study also investigates hospitalization trends and examines variations in morbidity and
mortality among beneficiaries to gain deeper insights into the broader health outcomes associated with PM-
JAY implementation. The study draws on secondary data obtained from the annual reports of the National
Health Authority (NHA), as well as various academic journals and research articles. The findings reveal that
PM-JAY has played a significant role in reducing instances of distress financing and enhancing healthcare
accessibility, particularly among rural and low-income households. Furthermore, the broadened hospital
network and the surge in admissions under PM-JAY point to improved access to quality healthcare, increased
hospitalization rates, and a likely reduction in mortality. The study concludes that while PM-JAY has made
meaningful progress toward universal health coverage (UHC), sustained efforts in strengthening
implementation, monitoring, and public awareness are essential to ensure equitable and long-term socio-
economic benefits for all Indian households.
Keywords: PM-JAY, Ayushman Bharat, health insurance, socio-economic impact, out-of-pocket expenditure,
Indian households.
INTRODUCTION
The Indian Healthcare system is a combination of commercial companies, non-governmental organisations and
multiple levels of government that are involved in decision-making and service delivery. The accessibility to
adequate and quality medical care has become a significant issue in India.
1
The majority of Indians are not
covered by any kind of health insurance, resulting in high-out-pocket expenditure. This makes it difficult for
individuals to secure funds for their medical needs, adversely impacting their socio-economic well-being and
pushing them below the poverty line. In September 2018, Ayushman Bharat Pradhan Mantri Jan Arogya Yojna
(AB-PMJAY) health insurance scheme was launched by government of India to provide access to adequate
and quality healthcare to Indian families.
It provides financial healthcare coverage for nearly 50 crore
individuals and covers Rs.5 lakhs per family per year for secondary and tertiary care hospitalization across
public and private empanelled hospitals in India.
2
AB-PMJAY scheme is mainly implemented with a goal to
minimize out-of-pocket expenditure, which is a main barrier in Indian healthcare system. The scheme has a
major influence on the lives of many beneficiaries, particularly on the disadvantaged segments of the
population providing financial protection against catastrophic healthcare costs. This study aims to assess the
coverage of the PM-JAY scheme across various Indian states by measuring state-wise enrolment rates and
beneficiary penetration levels. It further evaluates the scheme’s effectiveness in reducing out-of-pocket
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healthcare expenses, mitigating catastrophic health spending and preventing poverty among low-income
households. Additionally, the study examines hospitalization rates and analyses trends in morbidity and
mortality among scheme beneficiaries to understand the broader health outcomes associated with PM-JAY
coverage. The research gap addressed in this study lies in the limited evidence on how the PM-JAY scheme’s
improvements in health insurance coverage and reductions in out-of-pocket and catastrophic healthcare
expenditures translate into broader socio-economic outcomes. While the scheme has shown promise in
financial risk protection, there is a lack of comprehensive analysis on its impact across different socio-
economic groups. This study seeks to bridge that gap by analysing the socio-economic impact of PM-JAY on
Indian households, with a focus on changes in savings, levels of debt and shifts in poverty status.
Overview of PM-JAY Achievements as of 2024
Metric
Statistic
Ayushman Cards issued
Over 41 crore (410 million).
Hospital admissions
Over 9.84 crore
Amount authorized
Over ₹1.40 lakh crore
Lives saved from poverty
Prevents approximately 6 crore Indians
Out-of-Pocket Expenditure (OOPE)
₹1.25 lakh crore saved in out-of-pocket expenses.
Reduced OOP from 62.6 percent (FY2015) to 39.4 percent
(FY2022) as a share of total health expenditure.
Empanelled hospitals
31,466 hospitals, including 14,194 private ones.
Gender equity
49 percent of Ayushman Cards issued to women.
48 percent of hospital admissions utilized by women.
(Source: https://nha.gov.in/PM-JAY )
The table presents an overview of PM-JAY’s key achievements, including the number of Ayushman cards
issued, hospital admissions, government funds authorized for beneficiaries, lives protected from poverty,
reduction in out-of-pocket healthcare expenses, number of empanelled hospitals, and progress toward gender
equity under the scheme.
Objectives:
The objectives of the study are:
To assess the coverage of the PM-JAY scheme across different states of India.
To analyse the impact of the PM-JAY scheme on the socio-economic status of beneficiaries
To study health outcomes linked to PM-JAY coverage.
REVIEW OF LITERATURE
A number of studies have examined various dimensions of the Ayushman Bharat Pradhan Mantri Jan Arogya
Yojana (AB-PMJAY), particularly its impact on awareness, utilization, and financial protection. However,
despite growing literature, several gaps remain regarding regional disparities, beneficiary experiences, and the
effectiveness of awareness mechanisms.
Sweety Patel (2024)
1
found that AB-PMJAY significantly reduced out-of-pocket (OOP) expenditure by
providing financial security, expanding access to healthcare, and standardizing treatment costs. Similarly,
Deborah Warren (2025)
3
reported a measurable decline in OOP expenditures and catastrophic health
spending among beneficiaries in Assam, especially in public hospitals. These studies collectively demonstrate
the scheme’s financial protection benefits. However, they primarily focus on the economic impact, leaving
gaps in understanding awareness levels, utilization behaviour, and administrative challenges influencing these
outcomes.
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Research on awareness and utilization has shown substantial regional and demographic variation. For instance,
Raghav Dixit et al. (2025)
2
found that rural beneficiaries in Gautam Buddha Nagar district displayed higher
awareness and utilization due to targeted campaigns and healthcare worker outreach, while urban residents
lacked proper guidance about the scheme. Likewise, Kamalpreet and Sonali Beri (2024)
5
observed moderate
awareness and usage levels, with government campaigns and healthcare providers being key information
sources. Despite these initiatives, enrolment and utilization remained low, particularly for non-hospitalization
services. These findings point to a gap between awareness creation and effective utilization, suggesting that
informational efforts are insufficient without proper follow-up and guidance.
Sona Ojha and Gopal Prasad (2025)
4
explored the policy implementation challenges of PM-JAY in rural
Uttar Pradesh, noting that systemic inefficiencies, such as weak beneficiary identification, limited
infrastructure, and poor interdepartmental coordination restricted the scheme’s success. Similarly, Vemuri
Sailaja Vani (2024)
6
found moderate awareness and enrolment rates in Andhra Pradesh but a utilization rate of
only 40 percent, with many still incurring out of pocket expenses. These studies underscore implementation
and operational barriers that limit the scheme’s effectiveness, but few have examined how these challenges
vary across rural–urban contexts or among different beneficiary groups.
At the national level, Divya Parmar et al. (2023)
7
and Bigi Thomas et al. (2023)
8
reported that while PM-
JAY contributed to reduced catastrophic health expenditures and encouraged greater use of private hospitals, a
substantial proportion of beneficiaries continued to face out of pocket costs even after enrolment. These
persistent expenditures suggest limitations in coverage awareness and hospital compliance, areas that remain
underexplored.
During the COVID-19 pandemic, Pallavi Omkar Sawant and Ashok Luhar (2021)
9
demonstrated that AB-
PMJAY acted as a crucial safety net for underprivileged populations, preventing deeper impoverishment.
However, Akshay et al. (2021)
10
showed that in specific sectors like oral healthcare, awareness remained as
low as 30 percent, and utilization was minimal. These findings indicate sector-specific underutilization and
uneven knowledge of benefits, especially for specialized care.
RESEARCH METHODOLOGY
The study is based on secondary data sourced from the annual reports of National Health Authority (NHA),
various journals, articles, and websites of NHA and PM-JAY. Literature searches were performed using google
scholar and research gate. The data covers the period from 2018-2019 to 2023-2024.
Data Analysis And Interpretation
Table 1 State-wise coverage of PM-JAY health insurance scheme in India
State/UT Name
No. of families covered
Percentage of families covered
Andaman and Nicobar Islands
23,785
0.02
Andhra Pradesh
1,41,78,220
9.30
Arunachal Pradesh
98,844
0.06
Assam
56,34,138
3.69
Bihar
1,21,10,525
7.94
Chandigarh
79,226
0.05
Chhattisgarh
64,70,172
4.24
Dadra and Nagar Haveli and Daman and Diu
1,88,657
0.12
Goa
41,098
0.03
Gujarat
95,47,134
6.26
Haryana
29,93,557
1.96
Himachal Pradesh
5,32,396
0.35
Jammu & Kashmir
25,05,626
1.64
Jharkhand
61,50,000
4.03
Karnataka
1,15,00,000
7.54
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Kerala
44,21,292
2.90
Ladakh
40,758
0.03
Lakshadweep
12,523
0.01
Madhya Pradesh
1,08,61,653
7.12
Maharashtra
93,05,910
6.10
Manipur
4,07,593
0.27
Meghalaya
6,88,551
0.45
Mizoram
2,16,584
0.14
Nagaland
3,50,453
0.23
Puducherry
1,92,082
0.13
Punjab
34,99,970
2.29
Rajasthan
66,37,371
4.35
Sikkim
44,228
0.03
Tamil Nadu
1,42,42,194
9.34
Telangana
90,10,000
5.91
Tripura
5,49,554
0.36
Uttar Pradesh
1,80,47,024
11.83
Uttarakhand
19,49,364
1.28
Total
15,25,30,482
100
(Source: National Health Authority – Annual Report – 2022-2023)
The above table depicts the coverage of PM-JAY Health Insurance scheme across different states of India. The
top 3 states benefiting from the scheme are Uttar Pradesh which ranks first with 1,80,47,024 families covered
(11.83 percent), followed by Tamil Nadu with 1,42,42,194 families (9.34 percent) and Andhra Pradesh cover
1,41,78,220 families (9.30 percent).
Some of the States/Union Territories like Andaman and Nicobar Islands, Arunachal Pradesh, Chandigarh,
Dadra and Nagar Haveli and Daman and Diu, Goa, Himachal Pradesh, Ladakh, Lakshadweep, Manipur,
Meghalaya, Mizoram, Nagaland, Puducherry, Sikkim and Tripura covered less than 1 percent of families under
PM-JAY Health Insurance scheme.
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Table 2 Utilization of PM-JAY health insurance scheme
Financial year
Funds released/utilized
(Amount in crore)
Percentage of change in funds
released/utilized
2018-2019
1,965
-
2019-2020
3,129
59.24
2020-2021
2,636
-15.76
2021-2022
3,066
16.31
2022-2023
6,048
97.26
2023-2024
6,554
8.37
2024-2025
4,365
-33.40
(Source: https://www.mohfw.gov.in - Annual Report – 2024-2025)
From the above table it is observed that the funds released/utilized have showed an upward trend, rising from
Rs.1,965 crore in 2018-2019 to Rs.6,554 crore in 2023-2024, before witnessing a dip in 2024-2025. The
utilization percentage increased from 59.24 percent in 2019-2020 to 97.26 percent in 2022-2023. However, it
dropped sharply to 8.37 percent in 2023–2024 and further declined to a negative 33.40 percent in 2024–2025.
Table 3 Financial impact of PM-JAY on Indian households
Metric
Before PM-JAY
(Approx. FY 2015)
After PM-JAY (Approx.
FY 2022)
National out-of-pocket expenditure (OOPE) (as a
percent of total health expenditure)
62.6
39.4
Cumulative OOPE savings (Estimated)
-
Over ₹1.25 lakh crore
Estimated Indians saved from poverty
-
6 crore individuals annually
Health insurance coverage in rural areas (in percent)
26.9
38.6
(Source: https://nha.gov.in/PM-JAY )
The table clearly shows that the national out-of-pocket expenditure, which was 62.6 percent of the total health
expenditure before the implementation of PM-JAY scheme, has decreased to 39.4 percent after the introduction
of PM-JAY scheme. This represents a 23.2 percent reduction in out-of-pocket expenditure following the
implementation of the PM-JAY scheme.Following the introduction of the PM-JAY scheme, the cumulative
out-of-pocket expenditure savings exceeded Rs.1.25 lakh crore. It is estimated that the scheme has helped to
prevent around 6 crore individuals from falling into poverty each year.The health insurance coverage in rural
areas was 26.9 percent before the implementation of PM-JAY scheme and increased to 38.6 percent after the
introduction of PM-JAY scheme. A difference of 11.7 percent was observed following the introduction of the
PM-JAY scheme.
Thus, the PM-JAY health insurance scheme has achieved the primary goal of reducing catastrophic health
spending for vulnerable families and it is also successful in preventing poverty caused by health expenses.
Table 4 Maternal and child health indicators
Metric
Non-PM-JAY states (FY
2015–20) (in percent)
PM-JAY states (FY
2015–20) (in percent)
Infant Mortality Rate (IMR) reduction
12
20
Under-5 Mortality Rate (U5MR) reduction
14
19
Women with unmet family planning needs
Decreased by 10
Decreased by 31
Women with HIV/AIDS knowledge
Increased by 2
Increased by 13
(Source: https://nha.gov.in/PM-JAY )
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The table clearly indicates that the Infant Mortality Rate (IMR) reduction was 12 percent in Non-PM-JAY
states and 20 percent in PM-JAY states. The Under-5 Mortality Rate (U5MR) reduction was 14 percent in
Non-PM-JAY states and 19 percent in PM-JAY states. The proportion of women with unmet family planning
needs declined by 10 percent in Non-PM-JAY states, while PM-JAY states saw a more significant reduction of
31 percent. The percentage of women with HIV/AIDS knowledge increased by 2 percent in Non-PM-JAY
states, whereas PM-JAY states experienced a more substantial increase of 13 percent.
Thus, the states that implemented PM-JAY health insurance scheme demonstrated better maternal and
childcare outcomes compared to non-implemented states.
Table 5 Hospital network under PM-JAY health insurance scheme
Year
No of empanelled
public hospitals
No of empanelled
private hospitals
Total number of
empanelled hospitals
Percentage increase in total
number of empanelled hospitals
2018
3,417
1,941
5,358
-
2019
6,549
5,252
11,801
120.25
2020
11,774
6,931
18,705
58.50
2021
12,898
8,382
21,280
13.77
2022
14,862
10,176
25,038
17.66
2023
15,276
12,077
27,353
9.25
(Source: National Health Authority – Annual Report – 2022-2023)
From the above table it is evident that the number of empanelled public hospitals increased from 3,417 in 2018
to 15,276 in 2023. Similarly, the number of empanelled private hospitals also increased from 1,941 in 2018 to
12,077 in 2023.
The hospital network under PM-JAY scheme, comprising both public and private hospitals, increased from
5,358 in 2018 to 27,353 in 2023. In 2019 alone, the total number of empanelled hospitals rose by 120.25
percent, while by 2023 the growth rate had slowed to 9.25 percent.
3.417
6.549
11.774
12.898
14.862
15.276
1.941
5.252
6.931
8.382
10.176
12.077
5.358
11.801
18.705
21,280
25.038
27.353
0 5 10 15 20 25 30
2018
2019
2020
2021
2022
2023
Year
Hospital Network under PM-JAY Health
Insurance scheme
Total No of empanelled Private Hospitals No of empanelled Public Hospitals
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Table 6 In-patient beneficiaries under PM-JAY health insurance scheme
Year
In-patient beneficiaries
in Public Hospitals (in
Lakhs)
In-patient beneficiaries
in Private Hospitals (in
Lakhs)
Total number of in-
patient beneficiaries
(in Lakhs)
Percentage increase
in total number of in-
patient beneficiaries
2019
18
25
43
-
2020
58
64
122
183.72
2021
105
122
227
86.07
2022
188
208
396
74.45
2023
277
282
559
41.16
(Source: National Health Authority – Annual Report – 2022-2023)
The data indicates that in-patient beneficiaries in public hospitals raised from 18 lakhs in 2019 to 277 lakhs in
2023. Similarly, in-patient beneficiaries in private hospitals also raised from 25 lakhs in 2019 to 282 lakhs in
2023.
The number of in-patient beneficiaries in both public and private hospitals increased substantially from 43
lakhs in 2019 to 559 lakhs in 2023. The year-on-year increase hit 183.72 percent in 2020, before falling to
41.16 percent by 2023.
Table 7 Utilization of public healthcare facilities under PM-JAY health insurance scheme (In terms of count)
Year
Percentage of utilization of public healthcare facilities (In terms of count)
2019
42
2020
47
2021
46
2022
48
2023
50
(Source: National Health Authority – Annual Report – 2022-2023)
The table indicates that the utilization of public healthcare facilities in terms of count increased from 42
percent in 2019 to 50 percent in 2023.
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Table 8 Utilization of public healthcare facilities under PM-JAY health insurance scheme (In terms of amount)
Year
Percentage of utilization of public healthcare facilities (In terms of amount)
2019
30
2020
33
2021
31
2022
32
2023
33
(Source: National Health Authority – Annual Report – 2022-2023)
The table shows that the utilization of public healthcare facilities in terms of amount increased from 30 percent
in 2019 to 33 percent in 2023.
The utilization was found to be slightly higher for the public healthcare facilities, compared to private
healthcare facilities registering an increase of 8 percent in the number of cases and 3 percent in the amount
spent.
42
47
46
48
50
2019 2020 2021 2022 2023
Year
Percentage of Utilization of Public
Healthcare Facilities (In terms of count)
Percentage of
utilization of public
healthcare facilities
(In terms of count)
30
33
31
32
33
28.5
29
29.5
30
30.5
31
31.5
32
32.5
33
33.5
2019 2020 2021 2022 2023
Year
Percentage of Utilization of Public Healthcare Facilities
(In terms of amount)
Percentage of utilization of public healthcare facilities (In terms of amount)
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FINDINGS
The PM-JAY health insurance scheme has provided coverage to 15,25,30,482 families across various
states in India, with Uttar Pradesh, Tamil Nadu, and Andhra Pradesh emerging as the top three
beneficiary states.
The consistent rise in funds released/utilized under the scheme from Rs.1,965 crore in 2018-2019 to
Rs.6,554 crore in 2023-2024, indicates a steady expansion in its coverage and implementation.
However, the dip in 2024-2025 may suggest factors such as budgetary constraints, improved fund
utilization efficiency or a slowdown in new enrolments and claims.
Following the introduction of the PM-JAY scheme, there was a reduction of 23.2 percent in out-of-
pocket expenditure, resulting in cumulative savings of over Rs.1.25 lakh crore. Additionally, the
scheme has helped to prevent around 6 crore individuals from falling into poverty each year.
The states that implemented the PM-JAY health insurance scheme showed improved maternal and
child health outcomes compared to those that did not implement the scheme.
The hospital network under the PM-JAY scheme, encompassing both public and private hospitals,
increased significantly from 5,358 hospitals in 2018 to 27,353 hospitals in 2023. In 2019 alone, the
total number of empanelled hospitals rose by 120.25 percent, while by 2023 the growth rate had slowed
to 9.25 percent.
The number of in-patient beneficiaries in both public and private hospitals increased substantially
from 43 lakhs in 2019 to 559 lakhs in 2023. The year-on-year increase hit 183.72 percent in 2020,
before falling to 41.16 percent by 2023.
Under the PM-JAY scheme, public healthcare facilities saw slightly higher utilization than private
healthcare facilities, experiencing an 8 percent increase in the number of cases and a 3 percent rise
in the amount spent.
DISCUSSION
The study found that PM-JAY is associated with reductions in out-of-pocket expenditures and catastrophic
health expenditures for eligible households.(Divya Parmar, e. a. (2023).) in the survey of around 57,000
eligible people in six Indian states found that the Pradhan Mantri Jan Arogya Yojana (PM-JAY) was linked to a
13 percent drop in out-of-pocket spending and a 21 percent drop in catastrophic health costs, mainly due
to use of private hospitals. Moreover, the “Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana” umbrella
scheme is credited in the government’s Economic Survey 2023-24 with generating savings of over ₹1.25
lakh crore in OOPE and shielding households from micro-economic shocks. Complementing the financial
protection effect, by early 2024 the scheme’s provider network had expanded to encompass nearly 30,000
empanelled hospitals nationwide, thereby enhancing access and choice for eligible populations.
Suggestions
Many studies have examined the beneficiaries covered under the PM-JAY scheme; however, limited
research has focused on comparing the scheme’s outcomes across states. Future studies could therefore
analyse PM-JAY outcomes across regions with differing levels of efficiency to better identify the
factors influencing program performance.
Several states still have relatively low coverage under the PM-JAY scheme; therefore, future studies
could explore the barriers to enrolment and access, including limited awareness, low literacy, and
documentation challenges.
There is significant scope for future research to examine how digital platforms such as the PM-JAY IT
system and beneficiary database could contribute to enhance the efficiency and transparency of the
PM-JAY health insurance scheme.
Further research could also explore ways to strengthen the PM-JAY scheme to enhance its preparedness
and responsiveness during future public health emergencies, such as pandemics or large-scale disease
outbreaks, by assessing its capacity for rapid service delivery, financial protection, and coordination
with other health systems.
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CONCLUSION
The study highlights the transformative potential of the PM-JAY health insurance scheme in improving the
healthcare access and financial security of Indian households, particularly those in economically vulnerable
sections. Findings indicate that PM-JAY has significantly reduced out-of-pocket medical expenditures for
enrolled families, thereby mitigating the risk of catastrophic health spending and indebtedness. The expansion
of the hospital network and the rise in hospital admissions under the PM-JAY scheme indicate improved
hospitalization rates, enhanced access to quality treatment, and a potential reduction in mortality rates. The
main limitation of the study is that it relies on secondary sources, which may not capture all the aspects of
household experiences or regional disparities in PM-JAY implementation. The future research could
incorporate primary data collection through household surveys and interviews, which would provide a more
comprehensive understanding of how PM-JAY impacts households, capturing variations in utilization,
satisfaction, financial protection, and regional disparities. Thus, PM-JAY represents a pivotal step toward
achieving universal health coverage in India. By reducing financial vulnerability and promoting equitable
access to healthcare, it plays a crucial role in fostering social and economic resilience among Indian
households.
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