Faculty of Public Health - Andalas University - OCS, 13th IEA SEA Meeting and ICPH - SDev

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Health insurance for the Indian poor: an impact assessment of Rastriya Swasthya Bima Yojana on access to care and financial risk protection
Madhumita Bango, Gyan Chandra Kashyap

Last modified: 2018-08-07



In India, a significant proportion of the population is impoverished because of high out-of-pocket health-care expenditures. To minimise this economic hardship, Government of India launched Rashtriya Swasthya Bima Yojana to provide health insurance to poor households across India to protect them from major health shocks that push them into poverty and indebtedness.

Materials and Methods

The study has utilised 71st round of NSSO data. Study considered only those states who didn’t have any PFHI schemes except RSBY. To assess the impact of the scheme matching algorithm Coarsened Exact Matching (CEM), linear, and logit regression model have been carried out.


Only 11% households of the selected states were enrolled to RSBY and half of the households from the selected states who were enrolled belongs to a non-poor category. Result shows that hospitalisation rate under this scheme has been increased, but at the same time it’s not been clear that it’s increased people’s affordability for inpatient care or not. A substantial increase in enrolment has been seen among SC/STs. But, it has hardly had any effects on financial risk protection.


The experiences of PFHI indicate that targeted health insurance coupled with a healthcare delivery system dominated by private providers cannot be the means to achieve universal healthcare.