Evaluate the role of Ayushman Bharat-PMJAY in improving financial protection in healthcare, using recent NFHS data as evidence.

Financial protection in health means shielding households from catastrophic out-of-pocket (OOP) spending that pushes them into poverty. Launched in 2018, Ayushman Bharat-PMJAY offers ₹5 lakh annual cover to poor and vulnerable families. NFHS-6 (2023-24) offers fresh evidence to weigh its impact [1].

Evidence of gains

• Insurance expansion: Household coverage under any health-financing scheme nearly doubled from 41.0% (NFHS-5) to 60.2% (NFHS-6), largely anchored by PMJAY [1].
• Institutional access: Institutional deliveries rose to 90.6% and full ANC and immunization improved, reducing OOP spikes at points of care [1].
• Public-facility reliance: With 95.6% of childhood vaccinations delivered through public facilities, demand-side financing has strengthened trust in the public system [1].
• Equity: The scheme's expanding reach complements maternal-health gains, easing the poverty-inducing burden of hospitalization on low-income families [1].

Persisting limitations

• Coverage of ~60% households means a large uninsured "missing middle" remains outside PMJAY and ESIC/CGHS.
• NFHS captures enrolment, not utilisation or claim-settlement quality; OOP spending on outpatient care, diagnostics and drugs—the bulk of health expenditure—stays uncovered.
• Regional gaps persist; the survey excluded Manipur, and empanelment is uneven across states [2].

PMJAY has demonstrably widened the financial-protection net, as NFHS-6's insurance and institutional-access data confirm, yet gaps in the missing middle and outpatient costs endure. Extending outpatient cover and universalising enrolment would advance India toward SDG-3's Universal Health Coverage goal.