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 Resident Fellow with the Public Law vertical. At Vidhi, she has advised several Ministries and public institutions of the Government of India, and the State Governments of Delhi and Karnataka. She has advised on projects relating to privacy and data protection, regulation of the digital economy, platform governance, cybersecurity and allied areas at the intersection of law and technology. She has also worked on research projects relating to school and higher education, public health, transport and urban governance, digital inclusion etc. Her research interests include constitutional law, governance reforms, tech policy, education and child rights, media law etc. Akriti graduated with a B.A. LL.B (Business Law Hons.) from the National Law University, Jodhpur in 2015. She regularly writes for media outlets such as the Hindu, Wire, Indian Express, EPW, Financial Express etc. She has published academic articles in journals like the Indian Journal of International Law and the Comparative Constitutional Law and Administrative Law Quarterly, and contributed Book chapters to volumes published by the Cambridge University Press and Oxford University Press (forthcoming). Link to full bio

About Akshat Agarwal:

Akshat is a Research Fellow at Vidhi and currently works with the Vidhi Aid initiative. At Vidhi, he has advised on projects relating to the regulation of the digital economy, privacy and federalism. Currently, he is working on research projects relating to LGBT+ rights, withdrawal of care from terminally ill patients and public health. His research interests include public law, human rights, family law and gender and sexuality. Akshat is an alumnus of the National Law School of India University, Bangalore and was previously an Associate at the leading Indian law firm Khaitan & Co., where he worked with their disputes and regulatory practices. He has been published in peer reviewed journals as well as media outlets such as The Wire, LiveMint etc., and has also contributed to international blogs such as the Oxford Human Rights Hub and the IACL-AIDC blog. He served as the Chief Editor of the National Law School of India Review and was also on the editorial board of the Indian Journal of International Economic Law. Link to full bio

About Arghya Sengupta:

Arghya is the Founder and Research Director at Vidhi. His areas of specialisation are constitutional law and regulation of the digital economy. He has served on a number of government committees including most recently the Justice B.N. Srikrishna-led committee of experts on a data protection framework for India. Arghya has a number of academic publications on the Supreme Court, Parliament, fundamental rights in leading law journals such as Law Quarterly Review and Public Law. He is also a columnist at The Telegraph, The Hindustan Times and The Times of India. He has most recently authored a book "Independence and Accountability of the Indian Higher Judiciary" (Cambridge, 2019) which builds on his doctoral work at Oxford University. Prior to founding Vidhi, he was at Oxford as a Lecturer in Administrative Law at Pembroke College. Link to full bio

About Dhvani Mehta:

Dr. Dhvani Mehta {B.L.S. LL.B. (University of Mumbai); BCL, D.Phil (Oxon)} is a Senior Resident Fellow and Team Lead of the Vidhi Aid initiative, where she works on environmental and health regulation, medical ethics and the right to education. She has worked specifically on research projects on environmental clearances, the National Green Tribunal, organ transplant laws, end of life care, and pharmaceutical and medical device regulation. She has appeared in the Supreme Court of India in petitions filed by Vidhi on advance medical directives and discrimination against persons affected by leprosy. She has authored chapters on the implementation of environmental judgments and healthcare corruption in India. Dhvani read for a doctoral degree at the University of Oxford on a Rhodes Scholarship, where she was Chairperson of Oxford Pro Bono Publico and an editor of the Oxford Human Rights Hub blog. Her doctoral thesis explores the idea of an environmental rule of law in India and was cited by the Supreme Court of India.

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 with the Corporate Law and Financial Regulation vertical. Her areas of interest include the intersection of law and digital economy and business and human rights. At Vidhi, she has worked with various Ministries/Departments and a multilateral institution on various projects involving research and drafting support on areas diverse areas including financial resolution, digital economy (including payment systems law), business and human rights and competition law. Shehnaz graduated from RML National Law University in 2011. She has authored independent projects on tech-based interventions for regulating payment wallets, blueprint of a National Health Insurance Law and reforms for competition law. Prior to joining Vidhi, she headed a law firm (Zeta Law Chambers) co-founded by her, the Financial Regulatory Practice at Cyril Amarchand Mangaldas, Mumbai and the Dispute Resolution team at J. Sagar Associates. She has written for publications such as Oxford Business Law Blog, Financial Express, Firstpost and Business Standard.

About Shreya Shrivastava:

Shreya is a Research Fellow with the Vidhi Aid initiative. She is currently working on research projects related to inclusive education, early childhood development, medical devices regulation, healthcare applications and elimination of discrimination against leprosy affected persons. Her areas of interest include Right to Education, Constitutional law, Cyber law and the intersection of Health and Technology. Shreya graduated with a B.A. LL.B. (Hons.) from Hidayatullah National Law University, Raipur in 2018. She has been published in newspapers like The Hindu. She has co-authored the Centre for Civil Society’s ‘Compendium of laws to be repealed in Chhattisgarh’. In collaboration with the Centre for Communication Governance (CCG), she submitted an academic paper to MEITY on ‘Non-Consensual Obscene Content and Indian Law’. Prior to joining Vidhi, she has interned with policy organisations like CCG and the Land Rights Initiative at CPR, in the Chambers of Senior Advocate Prashant Bhushan, and with law firms like Karanjawala & Co and Samvaad Partners. Link to full bio