Launching Ayushman Bharat – an insurance cover of Rs 5 lakh per person per year – for every citizen over the age of 70, regardless of income level, Prime Minister Narendra Modi flagged how two Opposition-ruled states, West Bengal and Delhi, would not benefit as they had opted to stay out of the scheme.

The PM’s message that politics had come in the way of welfare resonates with data from the ground. Indeed, a clear trend six years into the scheme’s rollout is that a substantial share of the allocated funds has been utilised by Opposition-ruled states.

As of January 15, 2024, there have been 6.22 crore hospitalizations under the scheme, with government spending adding up to Rs 79,227 crore.

An analysis by The Indian Express showed that 45 percent of these hospitalizations took place in seven Opposition-ruled states—Tamil Nadu, Karnataka, Kerala, Jharkhand, Punjab, Telangana, and Himachal Pradesh.

Additionally, 33 per cent of the reimbursements for treatment were directed to these states, indicating the scheme’s strong impact across the political spectrum.

No wonder, the PM’s repeated references to Ayushman Bharat have underlined three key themes to show how it has stitched a safety net for vulnerable sections across political lines.

First, the scheme aims to significantly reduce out-of-pocket expenses for low-income households. Second, it opens doors to essential medical treatments and emergency care that were once beyond the financial reach of many families. Third, its impact is most visible within marginalised groups.

Politically, Modi emphasises that the scheme plays a crucial role in fostering trust; although health is primarily a state responsibility, this initiative has positioned the Central government as a key player in delivering free healthcare access across state lines.

Data from seven Opposition-ruled states highlights how the scheme is providing crucial financial relief for families who would otherwise struggle to afford specialised treatments, particularly for life-threatening or chronic conditions.

In Tamil Nadu, for example, top specialties funded were general surgery, paediatric medicine, and general medicine. Karnataka directed the majority of funds towards cardiology, cardio-thoracic & vascular surgery, and neurosurgery, while Kerala focused its spending on cardiology, general medicine, and orthopaedics.

In northern states, Punjab allocated most of its funds to orthopaedics, general surgery, and cardiology. Himachal Pradesh’s primary expenditure was on general surgery, general medicine, and cardiology, whereas Jharkhand concentrated its spending on ophthalmology, general surgery, and general medicine.

Spending patterns also highlight differing healthcare needs across regions. For example, southern states like Karnataka and Kerala have a high demand for cardiac and neuro-related procedures, while northern states like Punjab and Jharkhand prioritise orthopaedics and ophthalmology. This reflects how the scheme is flexible enough to meet region-specific healthcare demands.