Blueprint of a National Health Insurance Law
Creating a constitutionally valid and rights-based statutory basis for the Pradhan Mantri-Jan Arogya Yojana
Summary: The Constitutional division of legislative powers and India’s international obligations suggest that a national health insurance law should be non-discriminatory, provide for accountability, transparency and grievance redressal and monitoring mechanisms.
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.
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About the Authors
Akriti led the Centre for Applied Law and Technology Research (ALTR). At Vidhi, she advised several Ministries and public institutions of the Government of India, and the State Governments of Delhi and Karnataka, on drafting legislation and policies related to technology and constitutional law, digital inclusion, and education reform. 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. Her research interests include constitutional law, technology law, platforms and digital markets/FinTech, regulation of the sharing economy, AI governance and ethics, platformisation of speech, data governance, and privacy. Akriti graduated with a B.A. LL.B (Business Law Hons.) from the National Law University, Jodhpur in 2015.
Akshat was a Research Fellow at Vidhi. He has advised on projects relating to the regulation of the digital economy, privacy, federalism and healthare. His areas of research interest included constitutional law, gender and sexuality, family law and public health.
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 the 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 and the Constitution in leading law journals such as Law Quarterly Review and Public Law. He is also a columnist at The Telegraph 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.
Dr. Dhvani Mehta {B.L.S. LL.B. (University of Mumbai); BCL, D.Phil (Oxon)} is a Co-Founder at Vidhi and Lead, Health. 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.
Param was a Research Fellow at Vidhi.
Shehnaz is Senior Resident Fellow and Lead, Fintech and ALTR. She works on emerging areas of policy and law on the intersection of finance, technology, and inclusion. At Vidhi, she has worked with several Ministries of the Government of India on matters relating to digital payments, financial regulation, commercial laws and business and human rights. Her independent research at Vidhi focuses on leveraging technological solutions to build a robust and inclusive financial system for all in India. Prior to joining Vidhi, she worked as an associate at the Financial Regulatory Practice at Cyril Amarchand Mangaldas, Mumbai where her work focused on advising leading financial institutions (both Indian and multinational), including payment systems on legal and regulatory issues in India. She has also involved in several mergers and acquisitions in the financial space. She has also worked as an associate at the Dispute Resolution team at JSA, New Delhi. She writes frequently for the Oxford Business Law Blog and media outlets such as Hindu BusinessLine,Financial Express, MoneyControl, FirstPost, etc. She graduated from RML National Law University in 2011.
Shreya was a Senior Resident Fellow working in the area of Health and Education. She worked on research projects related to public health, patient rights and inclusive education. Her areas of interest include Public Health, 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 and websites like The Hindu and The Wire. 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 the Centre for Policy Research, in the Chambers of Senior Advocate Prashant Bhushan, and with law firms like Karanjawala & Co and Samvaad Partners.
