Lok Sabha Question No. 5712 (UNSTARRED), answered on 2026-03-27
Subject: Out-of-Pocket Expenditure on Health in Kerala
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Shafi Parambil

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 5712 TO BE ANSWERED ON 27 TH MARCH, 2026

## OUT-OF-POCKET EXPENDITURE ON HEALTH IN KERALA

## 5712 SHRI SHAFI PARAMBIL:

Will the Minister of HEALTHANDFAMILYWELFARE be pleased to state:

- (a) the percentage and per capita Out-Of-Pocket Expenditure (OOPE) on health in the State of Kerala during the last ten years, year-wise;
- (b) the comparative data on out-of-pocket health expenditure in other States and Union Territories during the same period;
- (c) whether Kerala's OOPE is higher or lower than the national average and if so, the reasons thereof;
- (d) the major components contributing to out-of-pocket expenditure in Kerala including medicines, diagnostics, hospitalization and outpatient care; and
- (e) the steps taken by the Union Government to reduce the financial burden on households, including the expansion of Ayushman Bharat and other health insurance schemes in the said State?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SMT. ANUPRIYAPATEL)

- (a) to (c): As per latest available National Health Accounts estimates, the per capita Out-OfPocket Expenditure (OOPE) and OOPE share in Total Health Expenditure (THE) for States, including Kerala, for FY 2014-15 to FY 2021-22 is placed at Annexure.
- (d) As per the NHA estimates for FY 2021-22, major components of OOPE at all India level is available at public domain and the URL is https://mohfw.gov.in/sites/default/files/NHA%202021-22\_up.pdf {Table A 3 -Current Health Expenditure (2021-22) by Healthcare Functions and Health Financing Schemes (HCxHF matrix)}.
- (e) The Government is committed to provide good quality health care services through increasing access, increasing affordability by lowering the cost of healthcare delivery and equity, including those in rural areas leading to reduce the financial burden on households across States/UTs including Kerala. Towards this, various schemes such as National Health Mission, Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission, Pradhan Mantri Swasthya Suraksha Yojana, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, among others are being implemented through DoHFW.

In order to strengthen public healthcare delivery, various measures are undertaken by Government of India. Under the NHM, the Government has taken many steps towards universal health coverage by supporting the State Governments in providing accessible and affordable healthcare to people. As per AAM portal, more than 1.8 lakh AAMs, including 7,200 approx. in Kerala, have been established to deliver the expanded range of comprehensive primary healthcare services that includes preventive, promotive, curative, palliative and rehabilitative services.

Further, under PM- Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), focus is on developing capacities of health systems and institutions across the continuum of care at all levels, primary, secondary and tertiary, to prepare health systems in responding effectively to the current and future pandemics /disasters.

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) aims to provide health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to more than 12 crore families constituting the economically vulnerable bottom 40% of India's population. States/UTs implementing AB-PMJAY have further expanded the beneficiary base, at their own cost. Additionally, the scheme has been expanded to cover 6 crore senior citizens of age 70 years and above belonging to 4.5 crore families irrespective of their socioeconomic status under AB-PMJAY with Vay Vandana Card. As on 28th February 2026, a total of 11.69 crore hospital admissions amounting to Rs. 1.73 lakh crore have been authorized under the scheme since its launch in September 2018, including 78.35 lakh hospital admissions amounting to Rs. 9,525.17 crore in Kerala.

Besides, quality generic medicines are made available at affordable prices to all under Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) in collaboration with the State Governments. Affordable Medicines and Reliable Implants for Treatment (AMRIT) Pharmacy stores have been set up in some hospitals/institutions.

*****

## Annexure referred to in reply to Part (a) to (c) of Lok Sabha Unstarred Question No. 5712 for reply on 27.03.2026 ANNEXURE

Statement showing per capita Out-Of-Pocket Expenditure (OOPE) and OOPE share in Total Health Expenditure (THE) for States including Kerala

| S. No   | States           | 2014-15   | 2014-15   | 2015-16   | 2015-16   | 2016-17   | 2016-17   | 2017-18   | 2017-18   | 2018-19   | 2018-19   | 2019-20   | 2019-20   | 2020-21   | 2020-21   | 2021-22   | 2021-22   |
|---------|------------------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|
| S. No   | States           | A         | B         | A         | B         | A         | B         | A         | B         | A         | B         | A         | B         | A         | B         | A         | B         |
| 1       | Andhra Pradesh   | 2,901     | 78.0      | 3,097     | 74.7      | 3,322     | 72.2      | 3,102     | 67.0      | 3,140     | 63.2      | 3,254     | 63.6      | 3,576     | 58.8      | 3,834     | 52.0      |
| 2       | Assam            | 1,293     | 63.1      | 1,315     | 55.1      | 1,378     | 53.8      | 883       | 35.9      | 949       | 36.7      | 998       | 34.9      | 1,064     | 33.2      | 1,180     | 27.6      |
| 3       | Bihar            | 1,685     | 82.3      | 1,776     | 79.9      | 1,830     | 77.6      | 808       | 58.2      | 811       | 53.5      | 863       | 54.3      | 911       | 50.2      | 984       | 41.3      |
| 4       | Chhattisgarh     | 1,838     | 58.3      | 1,971     | 58.4      | 2,040     | 55.9      | 1,186     | 38.8      | 1,175     | 38.3      | 1,253     | 36.7      | 1,356     | 33.9      | 1,419     | 29.2      |
| 5       | Gujarat          | 1,626     | 53.1      | 1,681     | 50.4      | 1,781     | 48.1      | 1,551     | 43.9      | 1,606     | 40.7      | 1,687     | 40.8      | 1,811     | 40.0      | 1,942     | 35.0      |
| 6       | Haryana          | 2,376     | 62.5      | 2,427     | 59.5      | 2,564     | 56.6      | 2,181     | 50.4      | 2,193     | 47.2      | 2,358     | 45.5      | 2,510     | 42.2      | 2,647     | 37.5      |
| 7       | Himachal Pradesh | 2,274     | 50.0      | 2,437     | 49.5      | 2,550     | 46.4      | 3,220     | 49.2      | 3,180     | 45.8      | 3,397     | 46.0      | 3,591     | 45.0      | 3,844     | 39.6      |
| 8       | Jammu &Kashmir   | 1,971     | 60.7      | 2,138     | 56.0      | 2,311     | 58.5      | 1,332     | 42.8      | 1,363     | 44.9      | 1,450     | 46.6      | 1,443     | 31.8      | 1,581     | 25.9      |
| 9       | Jharkhand        | 1,436     | 71.7      | 1,494     | 66.3      | 1,527     | 66.0      | 1,852     | 68.0      | 1,915     | 63.9      | 2,000     | 64.7      | 2,108     | 61.8      | 2,243     | 47.5      |
| 10      | Karnataka        | 2,282     | 52.2      | 2,447     | 49.6      | 2,548     | 49.2      | 1,549     | 34.2      | 1,625     | 33.3      | 1,722     | 31.8      | 1,810     | 30.3      | 1,933     | 25.4      |
| 11      | Kerala           | 5,023     | 73.9      | 5,111     | 71.3      | 5,419     | 67.0      | 6,363     | 68.7      | 6,772     | 68.6      | 7,206     | 67.9      | 7,669     | 65.7      | 7,889     | 59.1      |
| 12      | Madhya Pradesh   | 1,808     | 72.0      | 1,879     | 70.1      | 1,944     | 68.9      | 1,364     | 56.3      | 1,409     | 55.7      | 1,500     | 53.0      | 1,603     | 53.0      | 1,739     | 43.3      |
| 13      | Maharashtra      | 2,684     | 59.6      | 2,788     | 58.9      | 2,956     | 56.7      | 2,570     | 49.1      | 2,644     | 48.4      | 2,779     | 44.1      | 2,950     | 42.4      | 3,184     | 38.1      |
| 14      | Odisha           | 2,518     | 73.6      | 2,693     | 71.5      | 2,796     | 68.9      | 1,750     | 55.9      | 1,750     | 53.2      | 1,926     | 53.4      | 2,002     | 44.6      | 2,133     | 37.1      |
| 15      | Punjab           | 4,138     | 79.3      | 4,332     | 77.4      | 4,608     | 77.3      | 2,935     | 69.4      | 3,065     | 65.5      | 3,313     | 64.7      | 3,470     | 62.3      | 3,668     | 57.2      |
| 16      | Rajasthan        | 1,740     | 59.1      | 1,818     | 56.4      | 1,934     | 56.7      | 1,688     | 49.6      | 1,745     | 44.9      | 1,856     | 47.4      | 1,896     | 42.8      | 2,048     | 37.1      |
| 17      | Tamil Nadu       | 2,724     | 66.4      | 2,829     | 65.2      | 2,938     | 62.1      | 1,817     | 45.9      | 1,909     | 44.3      | 2,034     | 44.2      | 2,191     | 36.9      | 2,280     | 34.6      |
| 18      | Uttar Pradesh    | 2,396     | 78.3      | 2,469     | 76.5      | 2,597     | 74.8      | 2,393     | 72.6      | 2,481     | 71.3      | 2,670     | 71.8      | 2,775     | 70.2      | 3,014     | 63.7      |
| 19      | Uttarakhand      | 2,545     | 60.1      | 2,391     | 61.2      | 2,498     | 62.1      | 1,237     | 41.7      | 1,216     | 35.5      | 1,317     | 35.8      | 1,437     | 33.4      | 1,560     | 26.9      |
| 20      | Telangana        | 2,834     | 62.1      | 3,054     | 57.9      | NA        | NA        | 2,120     | 49.7      | 1,982     | 48.0      | 2,125     | 41.6      | 2,234     | 39.8      | 2,449     | 37.6      |
| 21      | West Bengal      | NA        | NA        | NA        | NA        | 3,169     | 74.1      | 3,115     | 69.8      | 3,208     | 68.7      | 3,425     | 67.1      | 3,648     | 65.1      | 4,010     | 58.3      |
| 22      | Al India         | 2,394     | 62.6      | 2,494     | 60.6      | 2,570     | 58.7      | 2,097     | 48.8      | 2,155     | 48.2      | 2,289     | 47.1      | 2,415     | 44.4      | 2,600     | 39.4      |