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

The government, which has finalised around 1,100 health benefit packages to be given under the National Health Protection Scheme (NHPS), plans to launch the new flagship programme on August 15. However, state governments are still deliberating the implementation model, cost and intended beneficiaries.

“We will hold another round of consultations with states as they are still seeking clarification. In the second round, we will finalise the architecture and various implementation models that states can adopt,” according to a senior official overseeing the roll-out 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 government wants to provide a health coverage of Rs 500,000 to about 40 per cent of the country’s population on a cost-sharing basis with states. The Centre will fund 60 per cent, whereas states will contribute the remaining 40 per cent.

The Prime Minister reviewed the progress of the scheme earlier this week and is learnt to have asked officials to speed up its implementation. The government plans 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 Yojana. The pilot will not be necessary,” the official added.

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 of both schemes are different.

The Centre’s scheme is based on the Socio Economic Caste Census, which identifies poor in seven deprived categories. Some states, including Rajasthan and Gujarat, cover people other than those listed in the deprived category. The Karnataka government recently announced that 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 to integrate the central and state schemes. There could be large overlaps and cost ramifications, since the Socio-Economic Caste Consensus (SECC) data was not seeded with Aadhaar. There could 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 was seeded with Aadhaar,” said the official quoted above. "States were also being given the option to issue two different cards, including one for the NHPS and another for the state scheme," he added.

Government officials said they had worked out the other modalities of the scheme, such as the 1,100 disease packages and ways to prevent fraudulent practices once the scheme was rolled out. The disease package could go up to 1,200, but it was still lower than what states, including Rajasthan, were currently offering. Rajasthan offers a maximum of 1401 disease package under its Bhamashah Swasthya Bima Yojana. The Centre is also getting ready with the back-end IT structure.