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As India’s flagship health insurance initiative, Ayushman Bharat (PM-JAY) has significantly expanded coverage, recently including all senior citizens aged 70 and above regardless of income. However, despite facing profound health vulnerabilities and financial barriers, persons with disabilities remain largely excluded from comprehensive coverage. An advocacy white paper released in November 2025 calls for the urgent and full inclusion of persons with disabilities in Ayushman Bharat, emphasizing the critical need for equitable, affordable healthcare for nearly 16 crore disabled Indians nationwide.
Key Developments and Findings
The National Centre for Promotion of Employment for Disabled People (NCPEDP) released a white paper highlighting that over 80% of persons with disabilities in India lack any form of health insurance, pointing to significant exclusion from schemes like Ayushman Bharat. Data derived from a nationwide survey of more than 5,000 persons with disabilities across 34 states and Union Territories between 2023 and 2025 revealed systemic barriers including high insurance premiums, inaccessible digital enrollment platforms, and frequent rejection of applications—especially among individuals with autism, psychosocial, intellectual disabilities, and blood disorders such as thalassemia. Over half of the applications by disabled individuals were reportedly rejected.
Arman Ali, Executive Director of NCPEDP, criticized the current policy gap, stating that despite equal or greater health vulnerabilities, persons with disabilities remain conspicuously excluded even as coverage expands for other vulnerable groups like senior citizens aged 70 and above. The report calls for the removal of age and income criteria to allow universal inclusion of persons with disabilities under the scheme.
Expert Perspectives and Commentary
Indu Bhushan, former CEO of Ayushman Bharat, acknowledged that while the scheme supports persons with disabilities to some extent, it does not sufficiently cover the full spectrum of health-related costs this population faces, such as mental health services, rehabilitation, and assistive technologies. She emphasized the need for universal health coverage to guarantee equal access to quality and affordable healthcare for all.
Anubha Mahajan, a Gurgaon-based public health expert and advocate living with Complex Regional Pain Syndrome (CRPS), underlined the critical link between disability and poverty. She argued that inclusion in Ayushman Bharat would provide a vital safety net, addressing financial barriers that prevent many disabled people from accessing essential care. She called for “true accessibility” that combines affordability with tailored healthcare services and simplified enrollment processes.
Manmeet Kaur Nanda, Additional Secretary in the Department of Empowerment of Persons with Disabilities (DEPwD), stressed the integration of government schemes with the Unique Disability ID (UDID) system to streamline beneficiaries’ access. She called for stronger collaboration between the Insurance Regulatory and Development Authority of India (IRDAI) and DEPwD to improve inclusivity in insurance schemes.
Context and Background
Launched in 2018, Ayushman Bharat—Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the world’s largest publicly funded health insurance scheme, providing up to Rs 5 lakh coverage per family annually for secondary and tertiary care hospitalization. The scheme targets around 12 crore economically vulnerable families (about 55 crore individuals), facilitating cashless hospitalization at empaneled hospitals across the country.
Recently, in September 2024, the government expanded Ayushman Bharat coverage to include all senior citizens aged 70 and above regardless of income or socio-economic status, recognizing their increased health risks and financial vulnerability. However, a similar inclusive expansion for persons with disabilities has not been implemented yet, despite evidence of their comparable if not higher need for financial protection from healthcare costs.
Public Health Implications
Including persons with disabilities in Ayushman Bharat without restrictions would significantly reduce catastrophic health expenditures for this marginalized group, many of whom live below the poverty line. It would also foster equitable access to complex and ongoing healthcare needs—including surgeries, mental health interventions, rehabilitation services, and assistive devices.
Given that disabled persons face higher health service utilization rates and co-morbidities, their exclusion perpetuates health inequities and financial hardship. Expanding the scheme’s coverage would also serve as a critical step toward achieving universal health coverage (UHC) goals in India, ensuring healthcare access regardless of disability status.
Potential Limitations and Counterarguments
The white paper acknowledges that universal inclusion poses administrative and financial challenges, including ensuring effective enrollment, minimizing application rejections, and expanding the scheme’s scope to cover specialized disability-related healthcare needs. There may also be a need to enhance healthcare infrastructure to meet increased demand.
Critics might argue about the fiscal sustainability of expanding benefits without income restrictions. However, proponents counter that the long-term societal and economic benefits of improved health outcomes justify the investment, especially when targeting one of the most vulnerable populations.
Practical Takeaways for Readers
For persons with disabilities and their caregivers, the current landscape highlights the importance of advocacy and awareness about available healthcare schemes. Although gaps remain, integrating government programs through the UDID system and ongoing policy advocacy signal progress toward inclusive health coverage.
Healthcare providers and policymakers must prioritize training and accessibility improvements to cater to the nuanced needs of disabled patients. For the general public, awareness and support for inclusive health policies can contribute to reducing stigma and promoting equity.
Medical Disclaimer
This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
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