Update on AB- PMJAY

1. At a Glance

AB-PMJAY (Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana) is the world's largest publicly funded health assurance scheme, offering ₹5 lakh/family/year cashless secondary & tertiary care cover [S2][S3].
Launched 23 September 2018 at Ranchi by PM Modi; flagship of Ministry of Health & Family Welfare (MoHFW), implemented by National Health Authority (NHA) [S2][S3].
Recent updates (Feb 2026) report empanelment progress, ABHA digital uptake, and expansion to 70+ senior citizens — high-yield Prelims + GS-II material [S1][S4].

PIB release, 3 Feb 2026: As on 31 Dec 2025, 15,733+ private hospitals empanelled under AB-PMJAY; 1,259 of them in aspirational districts [S1].
8.79 crore ABHA cards created under Ayushman Bharat Digital Mission (ABDM) in FY 2025–26 (as on 28 Jan 2026) [S1].
Follows Sept 2024 Cabinet expansion to all senior citizens aged 70+, and Apr 2025 entry of Delhi as 35th State/UT implementer [S4][S5].

2018: Announced in Union Budget 2018-19; launched 23 Sep 2018, Ranchi (Jharkhand) [S3].
Two pillars of Ayushman Bharat: (i) Health & Wellness Centres (now Ayushman Arogya Mandirs) under comprehensive primary care; (ii) PM-JAY for secondary/tertiary cover [S2].
Beneficiary base drawn from SECC 2011 (deprivation + occupational criteria); 10.74 cr families (~50 cr persons); revised in Jan 2022 to 12 cr families using 11.7% decadal growth [S2].
11 Sep 2024: Cabinet extends cover to all 70+ senior citizens irrespective of income — Ayushman Vay Vandana card [S4].
Apr 2025: Delhi becomes 35th State/UT implementer; Odisha onboarded via co-branded Gopabandhu Jan Arogya Yojana [S5].

Ministry: Health & Family Welfare; Implementing agency: National Health Authority (NHA) [S4].
Cover: ₹5 lakh/family/year, cashless, portable across India [S2].
Beneficiary base: 12 crore families (~55 crore persons) post-2022 revision [S2].
Senior-citizen expansion (Sept 2024): 6 cr seniors in 4.5 cr families; top-up ₹5 lakh for 70+ in already-covered families [S4].
Funding split: 60:40 (Centre:State) for most States; 90:10 for NE & Himalayan States; 100% Centre for UTs without legislature.
Empanelment portal: hem.nha.gov.in [S1].
Aspirational Districts Programme: NITI Aayog-led; 112 districts (relevant denominator for the 1,259 hospitals figure) [S1].

Social / Equity: Targets bottom 40% via SECC; senior-citizen expansion universalises by age band — shifts from purely poverty-based to categorical universalism [S2][S4].
Administrative: NHA-State Health Agency model; portability & IT backbone (BIS 2.0, Transaction Management System). Empanelment uneven — private hospital concentration low in aspirational districts (1,259 of 15,733 ≈ 8%) [S1].
Economic / Fiscal: Reduces catastrophic Out-of-Pocket Expenditure (OOPE); leverages private capacity (≈ 50%+ of empanelled hospitals are private) [S1].
Scientific / Tech: Convergence with ABDM — ABHA ID as unique health identifier; 8.79 cr ABHA cards in FY25-26 deepens Health Stack (UHI, HPR, HFR) [S1].
Governance / Federalism: Health is State subject (Entry 6, List II) — Centre relies on MoU-based opt-in; Delhi, West Bengal, Odisha refused for years; Delhi joined Apr 2025; WB still outside [S5].

11 Sep 2024: Cabinet nod for 70+ universal cover [S4].
Oct 2024: PM launches Ayushman Vay Vandana card; 25 lakh cards crossed shortly after.
Apr 2025: Delhi signs MoU — 35th State/UT [S5]; Odisha onboarded with co-branded card.
31 Dec 2025: 15,733 private hospitals empanelled; 1,259 in aspirational districts [S1].
28 Jan 2026: 8.79 cr ABHA cards created in FY 2025-26 [S1].

AB-PMJAY launched 23 September 2018 at Ranchi, Jharkhand [S3].
Cover: ₹5 lakh/family/year, secondary & tertiary care [S2].
Beneficiary base identified from SECC 2011; revised to 12 cr families in Jan 2022 [S2].
Implementing body: National Health Authority under MoHFW [S4].
15,733 private hospitals empanelled as on 31 Dec 2025 [S1].
1,259 empanelled private hospitals in aspirational districts [S1].
8.79 crore ABHA cards created in FY 2025-26 (as on 28 Jan 2026) [S1].
Ayushman Vay Vandana: card for 70+ citizens, approved 11 Sept 2024, income-agnostic [S4].
70+ in pre-covered families get additional ₹5 lakh top-up [S4].
Delhi became the 35th State/UT implementer (April 2025) [S5].
Empanelment search portal: hem.nha.gov.in [S1].
ABDM operationalises ABHA ID — 14-digit unique health ID.

GS-II: Welfare schemes for vulnerable sections; Issues relating to health, education, human resources.
GS-III: Inclusive growth; Government budgeting (subsidy & insurance).
Question stems: 1. "AB-PMJAY has shifted India's health financing from input-based subsidies to demand-side insurance. Critically examine." 2. "Evaluate the role of the Ayushman Bharat Digital Mission in operationalising universal health coverage in India." 3. "Universalisation of PM-JAY for 70+ citizens marks a paradigm shift from targeted to categorical entitlement. Discuss."

Ayushman Bharat Digital Mission (ABDM) — ABHA/UHI/HFR stack tied directly to PMJAY data flow.
Ayushman Arogya Mandirs (HWCs) — primary-care pillar of Ayushman Bharat.
National Health Policy 2017 — parent policy framework.
Aspirational Districts Programme (NITI Aayog) — denominator for empanelment metrics.
SECC 2011 — beneficiary identification base.
PMBJP (Jan Aushadhi) — complementary OOPE-reduction scheme.
PMSSY & PM-ABHIM — supply-side infra (AIIMS expansion, health infra mission).
Insurance Regulatory & Development Authority (IRDAI) — interface with private health insurance.

Not a universal scheme by default — base cover is SECC-targeted; only 70+ are universal post-2024.
Implementing body is NHA, not NITI Aayog or IRDAI.
Cover is per family, not per individual; no cap on family size; ₹5 lakh is annual.
States can opt out — Health is State List; West Bengal remains outside.
Ayushman Bharat ≠ PMJAY alone — it has two pillars (HWCs + PMJAY); ABDM is a distinct mission, often confused.
Aspirational districts total is 112 (NITI Aayog), not to be conflated with the 1,259 hospitals figure.

[S1] Update on AB-PMJAY (PIB, 3 Feb 2026) — https://www.pib.gov.in/PressReleasePage.aspx?PRID=2222495 — (tier 1)
[S2] Update on AB-PMJAY — https://www.pib.gov.in/PressReleasePage.aspx?PRID=2116209 — (tier 1)
[S3] AB-PMJAY launch announcement, 23 Sep 2018 — https://www.pib.gov.in/Pressreleaseshare.aspx?PRID=1546948 — (tier 1)
[S4] Cabinet approves 70+ senior citizen cover under AB PM-JAY — https://www.pib.gov.in/Pressreleaseshare.aspx?PRID=2053883 — (tier 1)
[S5] Delhi becomes 35th State/UT to implement AB PM-JAY — https://www.pib.gov.in/PressReleasePage.aspx?PRID=2119281 — (tier 1)