Are Publicly Funded Health Insurance Schemes Leading Towards Better Healthcare Utilization and Quality of Life? A Case Study from India

Abstract India introduced a new healthcare scheme, the Pradhan Mantri Jan Arogya Yojana (PMJAY), in 2018, which has been in effect since 2019. This scheme aims to achieve universal health coverage and supports the catastrophic Out-of-Pocket Expenditure (OOPE) of below poverty line population in Indian states. This study assesses the impact of PMJAY in two selected districts of the Indian state of Bihar considering a sample of 324 respondents. Propensity score matching (PSM) and entropy balancing (EB) are two widely used methods to ensure the robustness of impact assessment exercises. The EB method is considered relatively robust and therefore, we use and compare both. The average effect of PMJAY on the beneficiaries using EB shows a significant rise in healthcare utilization; the values are 2.51, 0.79 and 0.36 for OPD visits, hospitalizations, and surgeries, respectively. Our sample consists of 22 percent PMJAY-beneficiaries. The findings highlight the scheme’s potential to improve healthcare access and outcomes for the vulnerable population. Beneficiaries have reported better post-hospitalization quality of life and are more likely to return to work regularly after treatment. These insights may assist policymakers in further improving their effectiveness by raising awareness among the eligible households, as there are still barriers to enrollment and information asymmetries with regard to utilization.