More Indians covered by health insurance but overall percentage still low: NHFS-5

Health insurance coverage increased in the past five years in a majority of the Indian states and union territories but still remained well below half the population in most of them, according to the latest National Family Health Survey (NFHS-5).

As many as 15 of the 22 states and UTs surveyed showed an increase in the health coverage. Other than Andhra Pradesh, Telangana, Assam and Kerala, all major states have less than 50 per cent households with one member covered by a health scheme.  

Since the last survey done in 2015-16, there was a significant increase in Lakshadweep, Goa, Assam and Meghalaya. Kerala and Bihar recorded a minor improvement.

In September 2018, the Narendra Modi government in the Centre launched Pradhan Mantri Jan Arogya Yojana to provide health benefits to over 10 crore poor families. The scheme and other health finance benefits extended by some states around the same time, were widely popularised in awareness campaigns. 

Andhra Pradesh has the most households (70.2 per cent) where at least one member had a health scheme, although it has seen a decline in the last five years. This is followed by Goa (66 per cent) and Meghalaya (63.5 per cent).

Majority of the surveyed states have shown an increase in the number of households with a member covered under a health insurance scheme.

Tripura recorded the biggest decline — 25 percentage points in the last five years. The figure in remained the same in Karnataka since the last survey.  

Every second household in Mizoram, Kerala, Assam and Telangana and two out of every three households in Meghalaya, Goa and Andhra Pradesh were found covered under a health insurance scheme.

Andaman and Nicobar Islands, Jammu and Kashmir, Manipur, Bihar, Ladakh and Maharashtra reported less than 20 per cent households with at least one member covered under a health insurance scheme.

The ingrained regional inequality in health insurance coverage varies among the states and UTs. The difference between urban and rural regions of Assam, Telangana, Meghalaya, Mizoram, Tripura, Sikkim, Andhra Pradesh was found more than 10 per cent.

In majority of the surveyed states and union territories, coverage of health insurance is better in rural areas than in urban areas except in Himachal Pradesh, Sikkim and Jammu and Kashmir.

Bihar, Manipur and Jammu and Kashmir have a very low health insurance coverage both in rural and urban areas.

Of the overall 342 districts that were surveyed, insurance-covered households are lowest in the districts of Andaman and Nicobar Islands.

Most of the districts in Andhra Pradesh, Telangana, Assam and Meghalaya have 70 per cent or more families covered by health insurance. However, all other districts across the surveyed states and UTs show poor or low coverage.

A total of 25 dristricts in Bihar, Jammu and Kashmir, Manipur and Maharashtra reported 10 per cent or less households with any usual member covered under a health insurance/financing scheme.

A non-uniform inter-district variation emphasises the importance of the state-level initiative in boosting universal health cover.

Several reasons can be cited for the low health insurance coverage in India. One of the fundamental reasons can be the lack of awareness of people about the necessity of health schemes.

Secondly, health insurances are optional and so, many citizens tend to delay or ignore subscribing to one. To change this, the foremost task that needs to be carried out is sensitisation and awareness of the insurance schemes. 

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