West Bengal joins Ayushman Bharat scheme

West Bengal has officially joined the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), becoming the 36th state or Union Territory to implement t...

What Happened

West Bengal has officially joined the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), becoming the 36th state or Union Territory to implement the scheme.
The accession was formalised through a Memorandum of Understanding (MoU) between the National Health Authority (NHA) and the Government of West Bengal.
Approximately 1.43 crore families — comprising nearly 6 crore people — in West Bengal are expected to be covered, receiving up to Rs 5 lakh per family per year for secondary and tertiary hospitalisation.
West Bengal's previous state scheme, Swasthya Sathi, will be integrated: its approximately 6 crore beneficiaries will migrate to PM-JAY with effect from July 1, 2026.
The Union government approved a Rs 3,505 crore healthcare package for West Bengal as part of the rollout.
The portability feature of PM-JAY will particularly benefit migrant workers from West Bengal, who can now access cashless treatment at empanelled hospitals anywhere in the country.

Static Topic Bridges

Ayushman Bharat PM-JAY: Architecture and Scale

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) is the world's largest government-funded health assurance scheme by enrollment. It was launched in September 2018 under the Ayushman Bharat mission, which has two components: Health and Wellness Centres (HWCs) at the primary care level, and PM-JAY for secondary and tertiary hospitalisation coverage.

Coverage: Rs 5 lakh per family per year for hospitalisation across public and private empanelled hospitals.
Target beneficiaries: Approximately 12 crore families (55 crore individuals) — the bottom 40% of India's population, identified using the Socio-Economic Caste Census (SECC) 2011.
As of December 2025, 32,574 hospitals are empanelled, including 15,532 private hospitals.
Scheme is fully government-funded, with costs shared between the Centre and states (typically 60:40; for North-East and hilly states, 90:10).
The National Health Authority (NHA) is the apex implementation body under the Ministry of Health and Family Welfare.

Connection to this news: West Bengal's enrollment completes the near-universal geographic rollout of PM-JAY across India, representing a milestone in the country's health assurance architecture.

Health Federalism: Centre-State Dynamics in Health Policy

Health is a State subject under the Seventh Schedule of the Constitution (Entry 6 of the State List). However, the Union government operates several health schemes under its concurrent and residual powers — and Article 282 allows grants for public purposes. PM-JAY operates as a Centrally Sponsored Scheme (CSS), requiring state partnership and co-financing, which means states can opt in or out.

West Bengal had previously refused to join PM-JAY, preferring to operate its own Swasthya Sathi scheme — a reflection of state autonomy in health policy.
The change of government in West Bengal following the May 2026 assembly elections enabled the state's accession to PM-JAY.
States like Delhi and Odisha had also maintained their own parallel schemes before eventually joining or running hybrid implementations.
The NHA enables "state-equivalent" schemes to be integrated, allowing existing state beneficiaries to migrate to PM-JAY benefits.

Connection to this news: West Bengal's accession illustrates how political change at the state level can alter welfare scheme participation, and how Centre-State fiscal arrangements in health function under the CSS model.

One of PM-JAY's defining features is national portability — beneficiaries can access cashless treatment at any empanelled hospital across the country, regardless of their state of origin. This is operationally significant for India's estimated 10–15 crore internal migrants (with West Bengal being a major source state for interstate migration).

Pre-PM-JAY, most state health insurance schemes (like Swasthya Sathi) were restricted to hospitalisation within the state — creating a coverage gap for out-of-state migrants.
Internal migrants are a particularly vulnerable group: they often work in informal sectors without employer health benefits and cannot access welfare schemes of their home state.
The Aadhaar-linked PM-JAY card is the mechanism for beneficiary identification and portability; no referral or state-specific approval is needed for treatment at empanelled hospitals.
The e-Shram portal (for unorganised workers) and PM-JAY share beneficiary data to improve welfare targeting for migrants.

Connection to this news: With West Bengal home to large migrant worker outflows to states like Maharashtra, Karnataka, and Kerala, PM-JAY portability means these workers can now access cashless hospitalisation where they work, closing a critical protection gap.

SECC 2011 and Welfare Beneficiary Identification

The Socio-Economic Caste Census (SECC) 2011 was a nationwide survey conducted simultaneously with the 2011 Decennial Census to identify socio-economic status and caste composition of rural and urban households. PM-JAY uses SECC 2011 data to identify beneficiary households based on deprivation criteria for rural areas and occupational criteria for urban areas.

Rural deprivation criteria include: households without shelter, those with manual scavenging, landless households earning primarily from manual casual labour, etc.
Urban criteria include 11 occupational categories such as domestic workers, street vendors, construction workers, and sanitation workers.
SECC 2011 data is frozen for PM-JAY eligibility; there is ongoing policy debate about the need for an updated socio-economic census to prevent exclusion errors.
West Bengal's 1.43 crore eligible families were identified using this existing SECC 2011 dataset combined with Swasthya Sathi migration.

Connection to this news: The frozen beneficiary list from SECC 2011 may mean some West Bengal families who have since crossed into poverty since 2011 are excluded, while some who have improved their conditions may still be included — a structural targeting limitation of PM-JAY.

Key Facts & Data

West Bengal is the 36th state/UT to join AB PM-JAY.
Eligible West Bengal families: approximately 1.43 crore (nearly 6 crore individuals).
PM-JAY coverage: Rs 5 lakh per family per year for secondary and tertiary hospitalisation.
MoU signed between: National Health Authority (NHA) and Government of West Bengal.
Central healthcare package for West Bengal: Rs 3,505 crore.
West Bengal effective date: July 1, 2026 (Swasthya Sathi beneficiaries to migrate to PM-JAY).
Total PM-JAY empanelled hospitals (as of December 2025): 32,574 (including 15,532 private).
Nationwide PM-JAY target: 12 crore families / 55 crore individuals (bottom 40% of population).
Beneficiary identification basis: Socio-Economic Caste Census (SECC) 2011.
Centre-State cost-sharing ratio: 60:40 (general states); 90:10 (North-East and hilly states).