Assessing the Impact of Ayushman Bharat (PM-JAY) on Healthcare Access and Consumer Behaviour: An Exploratory Study in Haryana

Abstract

This study examines how Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), India's publicly funded health assurance scheme, has altered access to hospital care and the health-seeking behaviour of households in Haryana. The analytical concern is not the number of cards issued, but whether a cashless entitlement of ₹5 lakh per family per year changes the decisions that patients actually make: whether to seek treatment, when to seek it, where to go, what they still pay, and whether they trust the scheme enough to use it again. The study adopts an exploratory, secondary-data and policy-analysis design. Evidence is drawn from National Health Authority (NHA) and Ministry of Health and Family Welfare releases up to September 2026, the National Family Health Survey (NFHS-4, NFHS-5 and NFHS-6), the National Health Accounts, the Haryana State Health Authority, audit and media records on claim settlement, and peer-reviewed impact evaluations, including a recent case-control study from Haryana. Nationally, PM-JAY had funded 13.25 crore hospital admissions worth about ₹2.03 lakh crore by 31 August 2026, and more than 48.5 crore Ayushman cards had been created. Haryana has widened eligibility beyond the national criteria through the state-funded CHIRAYU extension linked to Parivar Pehchan Patra (PPP). The Haryana evidence shows that beneficiaries incur direct medical out-of-pocket expenditure about 65% lower than non-beneficiaries, and a much lower incidence of catastrophic health expenditure (13.3% against 45.9%). Similarly‚ indirect costs are not covered‚ and conflicts over delayed insurance payments‚ including unpaid claims totaling ₹1‚200 crore and a 24-hour shutdown of private hospitals in September 2026‚ undermine consumer confidence in PM-JAY․ Analysis in this paper suggests that PM-JAY has encouraged earlier and more use of formal and private-sector health care facilities among consumers‚ but sustaining these improvements will require addressing issues related to timely payments to providers and coverage of outpatient and indirect costs․