[The Ayushman Vay Vandana extension marks a shift from targeted to universal entitlement. Examine.](/upsc-mains-answer/ayushman-vay-vandana-extension-marks-shift-251e8b0)

Q. The Ayushman Vay Vandana extension marks a shift from targeted to universal entitlement. Examine. (15 marks, 250-350 words)

Article 47 casts a duty on the State to raise public health, yet AB PM-JAY was built as a deprivation-targeted assurance. The Vay Vandana extension for those aged 70+ genuinely breaks that logic — but only partially, for one cohort.

The original design was avowedly targeted - Beneficiary families were identified from SECC 2011 deprivation and occupational criteria, not from citizenship or residence [3]. - Cover of ₹5 lakh per family per year was confined to the bottom stratum for secondary and tertiary hospitalisation [2]. - Eligibility was thus means-determined; the non-poor, however vulnerable, stood outside.

How Vay Vandana marks the shift - The Union Cabinet approved cover for all senior citizens aged 70 and above irrespective of income, benefiting roughly 4.5 crore families and 6 crore seniors [1]. - Entitlement now flows from age, a demographic status, not from proven deprivation — the scheme's first income-agnostic element. - Seniors in already-covered families get a dedicated ₹5 lakh top-up not shared with younger members, recognising the individual, not merely the household [1]. - Near-nationwide onboarding — West Bengal becoming the 36th State/UT — plus portability gives the entitlement a pan-India character [4].

But the shift is calibrated, not complete - Universality is cohort-specific: the non-poor below 70 remain excluded [1]. - Benefits stay limited to hospitalisation; outpatient care, diagnostics and drugs, which drive most out-of-pocket spending, are outside [3]. - It remains an executive scheme, not a justiciable right; Article 47 is a non-enforceable Directive Principle [2]. - Delivery depends on 60:40 Centre-State cost-sharing and on State empanelment capacity, so uptake varies [2].

Vay Vandana therefore signals a directional move from targeted assurance toward universal health coverage, without yet completing it. Extending income-agnostic entitlement to the missing middle, adding outpatient benefits, and strengthening public hospital capacity would convert this promising beginning into substantive realisation of Article 47 and SDG-3.

(~320 words)

Sources: 1. Cabinet approves health coverage to all senior citizens aged 70 years and above irrespective of income under AB PM-JAY, PIB (11 Sept 2024) — income-agnostic 70+ cover, 4.5 crore families/6 crore seniors, dedicated ₹5 lakh top-up 2. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), PIB — ₹5 lakh family cover, secondary/tertiary scope, 60:40 Centre-State premium sharing 3. 5 Crore hospital admissions authorized under AB PM-JAY, PIB — SECC 2011 deprivation/occupational targeting; hospitalisation-only benefit design 4. West Bengal Becomes 36th State/UT to Implement Ayushman Bharat PM-JAY, PIB — 36th State/UT onboarding and nationwide portability