Modicare: Centre finalises 1,100 benefit packages, states still not ready

The Union government has finanlised around 1,100 health benefit packages to be given under the National Health Protection Scheme (NHPS), but state governments are yet to decide on the method to implement the health insurance scheme, apparently the world’s biggest, from August 15. “We will be holding another round of consultations with states as they are still seeking clarification. In the second round, we would be finalising the architecture and various implementation models that states can adopt,” says a senior official overseeing the rollout of the scheme. Last month, the Union health ministry and the NITI Aayog had called state health secretaries to apprise them about the NHPS, often dubbed as Modicare. Under the scheme, announced in the Union Budget, the Narendra Modi-led central government wants to provide a health coverage of Rs 500,000 to about 40 per cent the country’s population on a cost-sharing basis with the states. The Centre would be funding 60 per cent, whereas a state would have to contribute the remaining 40 per cent amount. Modi reviewed the progress of the scheme and is learnt to have asked official to speed up the implementation of the scheme in the penultimate year of his government’s present term. For this programme, the government is also planning to skip the pilot test usually carried out before implementing a major scheme or project in the country. “We already have the experience of running a similar scheme, the Rashtriya Swasthya Bima Yojna. The pilot will not be necessary,” the official adds. The success of the scheme, however, rests with states, which are currently finding it difficult to integrate the NHPS with their respective health insurance schemes, as the intended beneficiaries in both the schemes would be different.

The Centre’s scheme is based on the Socio Economic Caste Census, which identifies poor in seven deprived categories. Some states like Rajasthan and Gujarat cover people other than those listed in the deprived category. The Karnataka government recently announced it would cover all state residents in its health insurance scheme, while West Bengal has decided not to implement the NHPS. “The biggest challenge is integration of both the Centre and state schemes. There could be large overlaps and cost ramifications, as SECC data are not seeded with Aadhaar. There is also a possibility of exclusion of beneficiaries. So, states would be provided the flexibility to expand their existing schemes both vertically and horizontally till the time SECC data are seeded with Aadhaar,” the official quoted above explains. Officials in the government say they have worked out the other modalities of the scheme, such as the 1,100 health benefit packages and ways to prevent fraudulent practices once the scheme is rolled out. The IT infrastructure is also getting ready.