Lok Sabha Question No. 2936 (UNSTARRED), answered on 2016-12-02
Subject: Rashtriya Swasthya Bima Yojana
Ministry: HEALTH AND FAMILY WELFARE
Asked by: (ADV.) JOICE GEORGE, SRINIVAS KESINENI, ANSHUL VERMA, GOPAL CHINAYYA SHETTY

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2936 TO BE ANSWERED ON 2 ND DECEMBER, 2016

## RASHTRIYA SWASTHYA BIMA YOJANA

2936. ADV. JOICE GEORGE: SHRI KESINENI NANI: SHRI ANSHUL VERMA: SHRI GOPAL SHETTY:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the Government proposes to expand the personal health insurance and community health  insurance  schemes  in rural  and  semi - urban  areas in  the  country and  if  so,  the  details thereof;
- (b) whether the Government has any plan to make health insurance compulsory in the country and if so, the details thereof;
- (c) the details of the per capita cost of preventive and curative healthcare in the country and whether the Government has launched health insurance scheme for the poor in the country and if so, the details thereof;
- (d)  the  salient  features  of  such  health insurance  scheme  and  the  number  of  people who  got covered by this scheme so far, State - wise; and
- (e) whether the RashtriyaSwasthya BimaYojana (RSBY) covers all out - ofpocket expenditure on health and if so, the details thereof including the number of beneficiaries enlisted under RSBY?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF H EALTH AND FAMILY WELFARE (SHRI FAGGAN SINGH KULASTE)

- (a): The  number  of  lives  covered  under  Health  Insurance  policies  issued  by  General  a Health Insurers during the  Financial Year 2015 - 16 was 35.89 crore which is approximately 30 percent of India's tot al population. Further, IRDAI has notified IRDAI (Rural and Social Secto Obligations, 2015 that mandate every insurance company to offer insurance coverage to the and defined social sector population. All Insurers (life insurers, general insurers a nd standalone health  insurers)  shall  fulfill  the  stipulated  business  norms  towards  rural  and  soci obligations.

(c)&(d):: As  per  National  Health  Accounts,  Estimates  for  India  2013 - 14, published  by Ministry  of  Health  &  Family  Welfare,  the  expenditure  on  curative  care  is  estimated  a 3,38,477 crore (80.4% of Current Health Expenditure {CHE} which works out to be Rs. 2,7 per capita), of which Rs. 1,47,253 crores (35% of CHE) is the e stimated xpenditure on inpatient curative care and Rs. 1,91,214 crores (45.4% of CHE) is on outpatient curative care. The expenditure on preventive care is estimated at Rs. 40,627 crores (9.6% of CHE which works to Rs. 326 per capita).

Government of India has been implementing Rashtriya Swasthya Bima Yojana (RSBY) from 2008, a centrally sponsored health insurance scheme covers Below Poverty Line (BPL and  other  11  defined  designated  categories  such  as  (MGNREGA  Workers,  Construction Workers,  Do mestic  workers,  Sanitation  Workers,  Mine  Workers,  licensed  Railway  Porters, Street Vendors, Beedi Workers, Rickshaw Pullers, Rag Pickers and Auto/Taxi drivers), who a enrolled under RSBY. They are entitled for health insurance coverage of Rs.30,000/ -cas hless per annum per family. Beneficiaries need to pay Rs. 30/ -at the time enrollment. Transportation Cost upto Rs. 100 is also provisioned under the scheme. The details of beneficiary fam covered under RSBY is at Annexure.

(e): RSBY provides hospi talization coverage upto Rs. 30,000/ - per family per year. Hence out of pocket expenditure upto Rs. 30,000/ -per family per year is provided under RSBY.

## Annexure

| Annexure referred for Part (d)/Question No. 2936 to be answered on 02.12.2016   | Annexure referred for Part (d)/Question No. 2936 to be answered on 02.12.2016   | Annexure referred for Part (d)/Question No. 2936 to be answered on 02.12.2016   | Annexure referred for Part (d)/Question No. 2936 to be answered on 02.12.2016   |
|---------------------------------------------------------------------------------|---------------------------------------------------------------------------------|---------------------------------------------------------------------------------|---------------------------------------------------------------------------------|
| RSBY Scheme : Beneficiaries covered as on 31.10.2016                            | RSBY Scheme : Beneficiaries covered as on 31.10.2016                            | RSBY Scheme : Beneficiaries covered as on 31.10.2016                            | RSBY Scheme : Beneficiaries covered as on 31.10.2016                            |
| S.No.                                                                           | State                                                                           | Total Enrolled Families                                                         | Total Persons Covered                                                           |
| 1                                                                               | Assam                                                                           | 1421104                                                                         | 4333830                                                                         |
| 2                                                                               | Bihar                                                                           | 7085643                                                                         | 25818792                                                                        |
| 3                                                                               | Chhattisgarh                                                                    | 4019366                                                                         | 12981224                                                                        |
| 4                                                                               | Gujarat                                                                         | 2305614                                                                         | 9966883                                                                         |
| 5                                                                               | Himachal Pradesh                                                                | 480588                                                                          | 1553113                                                                         |
| 6                                                                               | Karnataka                                                                       | 6206620                                                                         | 20268427                                                                        |
| 7                                                                               | Kerala                                                                          | 2021572                                                                         | 6875392                                                                         |
| 8                                                                               | Manipur                                                                         | 70925                                                                           | 213229                                                                          |
| 9                                                                               | Meghalaya                                                                       | 256138                                                                          | 1043184                                                                         |
| 10                                                                              | Mizoram                                                                         | 194886                                                                          | 737047                                                                          |
| 11                                                                              | Odisha                                                                          | 4462959                                                                         | 14576041                                                                        |
| 12                                                                              | Tripura                                                                         | 492022                                                                          | 1871938                                                                         |
| 13                                                                              | West Bengal                                                                     | 6150716                                                                         | 22698471                                                                        |
| 14                                                                              | Nagaland                                                                        | Enrolment is under progress                                                     | Enrolment is under progress                                                     |
|                                                                                 | Grand Total                                                                     | 35168153                                                                        | 122937571                                                                       |

Note: Average family size is 3.49, therefore, the total number of persons covered is 35168153 X 3.49 = 122937571