New Analysis Finds that Modicare, One Year In, Lives Up to Its Promise

More than 500 million people now eligible to be covered by government-funded healthcare, researchers find

WASHINGTON – Modicare, the Indian government’s massive new health insurance program, has made over 500 million people eligible for healthcare coverage, marking a significant step toward universal health coverage in India, according to a new analysis from the Center for Global Development (CGD). Researchers at CGD examined data from the first year of Pradhan Mantri - Jan Arogya Yojana (PM-JAY), popularly known as “Modicare.”

“Modicare has put healthcare within reach for hundreds of millions, significantly increasing the number of people who have government-funded health insurance and far exceeding the initial estimates,” said Amanda Glassman, chief operating officer at CGD and one of the authors of the study. “We found that more than 500 million people are now eligible for coverage by Modicare or state-funded expansions of the program. That’s an impressive number, but there’s still lots of work to do to bring down costs and bring up quality.”

While the overall effort has been positive, the analysis highlights challenges and several potential pitfalls related to cost and quality that could derail Modicare’s progress. The researchers recommend:

• Focusing on quality. The government must take a more active approach in not just helping Indians pay for healthcare, but making sure they are getting the highest quality care possible, the researchers write. Additionally, the researchers explain that embracing and improving access to primary care and linking it with the hospitalization plan, rather than only providing hospitalization, would go a long way toward promoting better health.

• Emphasizing value for money. The focus in the first year of Modicare has been on expanding access to health insurance, the researchers write—but at some point, the government needs to take steps to tackle the costs of the program. These steps would include better purchasing policies for medical supplies and drugs and an increased focus on providing preventative health services like vaccines that could contain high costs of later treatment.

“India has done an impressive job expanding healthcare to hundreds of millions more people, but there’s still a lot of work to do. The next big step is making sure that that Modicare is sustainable and that it delivers the high-quality care that Indians need,” said Kalipso Chalkidou, a senior fellow at CGD and an author of the study.

You can read the analysis and the full list of recommendations to improve Modicare here: /publication/modicare-post-election-recommendations-enhance-impact-public-health-insurance-uhc-goals.

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