Patients in Rajasthan in a jam about Chiranjeevi card as private hospitals refuse treatment

Jaipur: Patients holding the Chiranjeevi Health Insurance Scheme guarantee card in Rajasthan find themselves in a dilemma regarding its efficacy at hospitals, particularly private ones. These hospitals are reportedly denying treatment while awaiting reimbursements from the government.

Priyanka Barman, who works as a household help, used the Insurance card to get her son treated at Jaipur’s Sawai Man Singh Hospital last July. She now wonders if the card can be useful again. She has heard that with the change of the government, the card has lost its utility. And that she would again have to do the camp rounds to get the new one. Her Bhamashah card made during Vasundhara Raje’s tenure is inoperative.

Most people from the deprived sections of society are now fed up with making and renewing guarantee cards, although they are touted as the government's massive social security initiatives. “I am thoroughly disgusted with new schemes, new cards every time after government changes. And this has been happening in Rajasthan for the last 25 years. Each time either the Congress or BJP come to power, they change the names and provisions of the scheme. And we have to stand in line every time, leaving our daily wage work,” says Radhey Mohan, a security guard.

Touted as former Chief Minister Ashok Gehlot’s flagship scheme, which was expected to bring him back to power, the Chiranjeevi Scheme offered cashless medical insurance of up to Rs 25 lakh. This universal health scheme has been available to all families of Rajasthan from May 1, 2021. The scheme was announced in the state budget of 2021-22.

With this scheme, Rajasthan became the first state to provide universal health insurance coverage to all.

The state Budget for 2023-24, raised the annual medical coverage amount from Rs 10 lakh to Rs 25 lakh with an accident cover of Rs 10 lakh. The scheme was initially launched with a coverage of Rs 5 lakh and was later increased to Rs 10 lakh with an additional accident cover worth Rs 5 lakh. Expensive treatments like heart transplants, liver transplants, bone marrow transplants and cochlear implants were also added to the scheme. Moreover, women heads of families covered under the Chiranjeevi Health Insurance scheme were also given smartphones with free internet connectivity for three years.

The Rajasthan government was paying the insurance premiums for all beneficiaries under the Mukhyamantri Chiranjeevi Swasthya Bima Yojana. However, all families apart from the beneficiaries were paying an annual premium of Rs 850 to avail of this scheme. Over 1.42 crore families were reportedly drawing benefits from the Chiranjeevi Scheme in Rajasthan.

With the change in government, there is no clarity on this particular scheme. With Gehlot questioning the continuity of the schemes, especially the Chiranjeevi scheme, the state government has not been very forthcoming on the issue.

Health activists point out that the private hospitals empanelled under the Chiranjeevi Scheme, are refusing to honour the card provisions for the time being and have turned away many patients.

Chhaya Pachauli, health activist and director of Prayas, Centre for Health Equity, told Deccan Herald: “Private hospitals are refusing to treat under the Chiranjeevi Scheme as they say their claims/dues from the state government are stuck. At present, as there is no clarity on the scheme, or the insurance amount limit, the hospitals are also apprehensive and do not want to take risks. They had stopped accepting the Chiranjeevi card before the election results were out, knowing if a new government came in, the name change, the benefits under it would all undergo some change.”

Pachauli adds: “Although there is talk of integrating the scheme with Centre’s Ayushman Bharat Scheme, there is nothing concrete yet. No minister has been given charge of the health ministry yet, and hence there is no directive from the government. There is no clarity regarding the model or the framework, if at all there is a new scheme.”

Pradhan Mantri Jan Arogya Yojana (PM-JAY), a component of the Ayushman Bharat Scheme, is the largest health insurance scheme launched by the Narendra Modi government which provides health cover of Rs 5 lakh per family per year for secondary and tertiary care hospitalisation to cover over 12 crore poor and vulnerable families, that form the bottom 40% of the population.

Pachauli informs: “The new BJP government has asked all card holders to get their KYC done, especially for the Jan-Aadhaar card, which works on the single card, single number, single identity philosophy and is necessary for availing the benefits of the state government’s various schemes including the Chiranjeevi."

There are also reports that the state government has instructed all district administration to issue new cards by Jan 26, especially during the ongoing Viksit Bharat Sankalp Yatra camps and to cover all Ayushman Bharat beneficiaries under it before the model code of conduct sets in, for the Lok Sabha polls likely to be held in April/May this year.

“The ambiguity regarding health is baffling. Now even the common man understands that guarantee cards and schemes are designed as a facade to garner votes. In the interim period, till the new government decides on the provisions of the new scheme and issues new cards, five years would be gone in a jiffy. Although the Lok Sabha polls may be one cause for the government to act quickly this time, what is the need to change names, new cards and waste time when the onus should be to provide a safe health ecosystem?” wonders Umaid Singh, a former panchayat member of Todaraisingh village in Tonk district.