Blueprint of a National Health Insurance Law

Reports by Public Law & Reports by Vidhi Aid · May 31, 2019
Author(s): Akriti Gaur, Akshat Agarwal, Arghya Sengupta, Dhvani Mehta, Param Pandya, Shehnaz Ahmed and Shreya Shrivastava

The Pradhan Mantri – Jan Arogya Yojana (PM-JAY) is part of the Government of India’s Ayushman Bharat initiative. It is a scheme that is aimed at protecting poor and vulnerable families against financial risk arising out of catastrophic health episodes, which have the potential of pushing such families into impoverishment. The National Health Authority (NHA) has been created by an executive notification to implement the PM-JAY. The PM-JAY offers a benefit cover of INR 5,00,000 per family per year to approximately 10.74 crore eligible families, towards hospitalisation expenses for secondary and tertiary care. PM-JAY is thus a scheme of far-reaching socio-economic importance.

Recently, the Government has proposed the conversion of the scheme to a legally enforceable statutory framework. In this context, this Concept Paper attempts to lay out the blueprint of such a National Health Insurance Law which is in line with India’s international obligations and is constitutionally sound. It proposes that such a law must be informed by a rights-based approach to ensure that it is not discriminatory, is accountable and transparent, and provides for a robust grievance redressal and monitoring mechanism. To ensure that a Central law is constitutionally sound, it proposes that a health insurance law can be enacted under ‘social insurance’ in Entry 23, List III of the Seventh Schedule of the Constitution. Past experiences of conversion of schemes into legislation and the convergence of State and Central schemes also provide instructive lessons for drafting such a law.

Click here to download the full report – ‘Blueprint of a National Health Insurance Law’.

About Akriti Gaur:

Akriti is a Senior Research Fellow in the Public Law vertical. She graduated with a Bachelor in Policy Science LL.B (Hons.) from National Law University, Jodhpur in 2015. Prior to joining Vidhi, she interned at the Planning Commission of India where she assisted the High Level Committee on Infrastructure Finance; the National Human Rights Commission and Chambers of Mr. Soli J. Sorabjee. She has also led student policy research groups in making recommendations to the Parliamentary Standing Committee and concerned ministries on Insurance laws and the Road Transport and Safety law. Her main areas of research at law school were in the field of corporate law, food law, arbitration and constitutional law. Link to full bio

About Akshat Agarwal:

Akshat is a Research Fellow at Vidhi and works with the Public Law vertical. He graduated with a B.A.,LL.B (Hons) from National Law School of India University, Bangalore in 2017. He has previously worked as an Associate at Khaitan & Co., in Mumbai in their general litigation and security and regulatory practices. He served as the Chief Editor of the National Law School of India Review and has previously interned with law firms such as AZB & Partners, Shardul Amarchand Mangaldas & Co, and was also part of Unilever's leadership internship programme. His areas of interest include regulation and public law, family law and legal history. Link to full bio

About Arghya Sengupta:

Arghya is the Founder and Research Director at Vidhi. He is an alumnus of National Law School of India University Bangalore and the University of Oxford where he was a Rhodes Scholar. While, at Oxford, he completed his D.Phil. on Independence and Accountability of the Indian Higher Judiciary and was a Lecturer in Administrative Law. His areas of specialisation are constitutional and administrative law. He has a number of academic publications on the Supreme Court, Parliament, fundamental rights and federalism and writes regularly for The Hindu, The Times of India and the Economic and Political Weekly. Link to full bio

About Dhvani Mehta:

Dhvani is a Senior Resident Fellow in Vidhi Aid. She has supervised research projects on the functioning of the National Green Tribunal, on grievance redressal mechanisms at public health establishments, and on the withdrawal of medical treatment from terminally-ill patients. She has assisted the Indian Council of Medical Research with regulatory reform on clinical trials and has provided legal research and drafting assistance to the Ranjit Roy Chaudhury Expert Committee constituted to suggest reforms to the Medical Council of India. Dhvani has a D.Phil in Law from Magdalen College, University of Oxford. Her doctorate explores the idea of an environmental rule of law in the Indian context and analyses the role of the legislature, executive and judiciary in strengthening or weakening it. Dhvani also has an M.Phil and BCL from Oxford and a B.L.S; LL.B from Government Law College, University of Mumbai.

About Param Pandya:

Param is a Research Fellow in the Corporate Law and Financial Regulation vertical. Prior to joining Vidhi, he worked in the General Corporate team at Cyril Amarchand Mangaldas, Mumbai (CAM), a leading law firm. His areas of interest include banking and corporate governance. He graduated with a B.Com. (LL.B.) (Hons.) from the Gujarat National Law University, Gandhinagar in 2015.

About Shehnaz Ahmed:

Shehnaz is a Senior Resident Fellow in the Corporate Law and Financial Regulation vertical. She graduated with a B.A.LL.B. (Hons.) from Dr. RML National Law University in 2011. Prior to joining Vidhi, she worked as a Partner at Zeta Law Chambers, Noida. She has also previously worked as an associate with J. Sagar Associates, New Delhi and the Financial and Regulatory practice team at Amarchand & Mangaldas & Sures A. Shroff. A & Co, Mumbai, wherein she worked on mergers and acquisitions in the financial sector and was also actively involved in advising some of the leading ‘payment systems’. Link to full bio

About Shreya Shrivastava:

Shreya is a Research Fellow with Vidhi Aid. She graduated with a B.A.LL.B. (Hons.) from Hidayatullah National Law University, Raipur in 2018. She has previously interned with Vidhi and worked on the Action Plan for curbing Air Pollution in Delhi, Computation of damages by NGT and Inclusive Education. She has also interned at Centre for Policy Research with the Land Rights Initiative; with Centre for Communication Governance, where she focused her research on the Legal & Policy Framework for Artificial Intelligence in India; with Supreme Court Commissioner’s Office in the Right to Food Case; in Chambers of Mr. Prashant Bhushan, Supreme Court of India and law firms like Karanjawala & Co and Samvaad Partners. She has also worked with Centre for Civil Society, where she co-authored the ‘Compendium of laws to be repealed in Chhattisgarh’.