India’s flagship health insurance scheme, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), has already made an indelible impact across the country. Since its launch in 2018, more than 8.19 crore people have availed services under the scheme, and ₹1.26 lakh crore have been spent under the same to provide healthcare services to the people of the country. The scheme has consistently focused on the most vulnerable – nearly 62 crore people, including women, senior citizens, and economically disadvantaged groups, now benefit from the ₹5 lakh annual coverage. Moreover, it’s not just about coverage; nearly 49% of Ayushman cardholders are women, a testament to the gender equity embedded in its design. From cancer treatments to cardiac surgeries, the scheme has helped prevent medical emergencies from becoming financial disasters. Notably, the out-of-pocket expenditure has declined from 62% to 38% today as a result of the Ayushman Bharat scheme.
In this nationwide success story, Odisha has long remained an outlier. The BJD government had resisted implementing PMJAY, relying instead on its own scheme, the Biju Swasthya Kalyan Yojana (BSKY). However, while BSKY might have its strengths, the larger truth remains that Odisha’s healthcare infrastructure has struggled under pressure for years. A recent CAG report revealed a system riddled with shortages, a nearly 27% shortfall in sub-centres, 23% in PHCs, and 12% in CHCs. Worse still, there’s a 64% deficit in hospital beds, and CHCs lack up to 79% of essential specialists like gynecologists and pediatricians. Patients are routinely forced to share beds, and critical care services, including ventilators and trauma units, are either defunct or nonexistent in many districts.
A massive human resource crisis compounds these infrastructural gaps. Odisha has just one doctor for every 1,622 people – well below the WHO norm of 1:1000. The nurse-patient ratio is even more alarming at 1:3,829. Diagnostics are largely unavailable or delayed due to staff shortages and malfunctioning equipment. At the community level, rural populations often endure hours-long travel to receive even basic care. For years, these issues have not only persisted but worsened, eroding public trust and forcing lakhs to depend on private facilities, when they can afford them.
This is precisely why Odisha’s recent decision to roll out Ayushman Bharat is a pivotal moment. Combined with its own Gopabandhu Jan Arogya Yojana (GJAY), Odisha’s new hybrid model promises comprehensive coverage to nearly 1.03 crore families. With a financial commitment of ₹27,019 crore over five years, this initiative is not just a policy move but a structural overhaul. Under the newly integrated system, coverage extends up to ₹15 lakh for families with senior citizens and ₹10 lakh for families with female members, making it one of the most inclusive public health insurance models.
The benefits extend beyond just financial protection. PMJAY’s convergence with the Health and Wellness Centres (now renamed Ayushman Arogya Mandirs) will ensure deeper primary care coverage. These centres, upgraded from sub-centres and PHCs, offer maternal and child healthcare, screenings for diabetes, cancer, and hypertension, mental health support, and rehabilitative services. Already, over 1.74 lakh such centres are operational nationwide, and Odisha will now receive ₹1,411 crore under the Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) to build critical care blocks, labs, and modern surveillance systems in its districts.
Critics may argue that the scheme’s success depends on efficient implementation, and they are right. But the national data suggests that states adopting PMJAY have seen sharper reductions in infant and under-five mortality rates, improved maternal health indicators, and even better credit performance due to reduced out-of-pocket health expenditure. Odisha’s late adoption may have delayed these gains, but it also means the state can now leapfrog by learning from best practices across India.
For Odisha, where public health has too often taken a back seat to political posturing, the integration of Ayushman Bharat is more than overdue; it’s essential. It can be the cornerstone of a new public health movement: one that brings healthcare to the doorstep of tribal villages, provides dignity to the elderly, empowers women, and relieves poor families from the crushing burden of medical debt.
If implemented with vision and accountability, Ayushman Bharat can be the game-changer Odisha has long waited for—not just a scheme, but a signal of systemic reform and social justice in action.
