Bengaluru: In what could be an after-effect of the Covid-19 pandemic, the proportion of households in Karnataka with at least one member covered under a health insurance or financing scheme has nearly doubled—from 31.8% in National Family Health Survey (NFHS)-5 (2019-21) to 63.3% in NFHS-6 (2023-24).Karnataka’s health insurance coverage is higher than the national average of 60.2%. The state ranks fifth in the country, behind Andhra Pradesh (91.9%), Rajasthan (88.7%), Odisha (82.7%), and Assam (70.3%). Interestingly, rural Karnataka, with 68.1% coverage, fares better than urban areas, where coverage stands at 57.1%. The survey was conducted across 27,169 households in the state.Experts attribute the sharp rise in coverage to a combination of increased health awareness following the pandemic, the expansion of govt-backed health coverage schemes, and rising household incomes.“After Covid, everyone is worried even about a viral fever or a common cold. During the pandemic, many people saw family members die, and since then there has been much greater concern about health,” said Kala Seetharam Sridhar, urban economist and professor at the Centre for Research in Urban Affairs, Institute for Social and Economic Change (ISEC).She added that rising incomes and improving educational levels may also have contributed to the increase in insurance coverage.“There is also increased income in many households now, along with higher educational attainment and greater awareness in general,” she said.Experts believe the growth of govt-sponsored health coverage schemes may explain why rural Karnataka has outperformed urban areas.“Essentially, there is no strong incentive for people to voluntarily purchase insurance. The higher coverage in rural areas could be due to the availability of better insurance products and govt schemes. While Covid-19 certainly increased awareness, I think the rise in rural coverage is more a result of supply than demand,” said N R Bhanumurthy, former vice-chancellor of Dr BR Ambedkar School of Economics University, Bengaluru.According to him, the deeper penetration of both state and central govt schemes has likely made health coverage more accessible to rural populations.The Centre provides health coverage through schemes such as the Employees’ State Insurance Scheme (ESIS) and the Central Govt Health Scheme (CGHS), while Karnataka offers the Yeshasvini scheme.According to a senior official in the state health department, around 35 lakh people in Karnataka avail benefits under ESIS, while a significant number are covered through the Yeshasvini scheme.The official noted that while Karnataka’s Ayushman Bharat-Arogya Karnataka (AB-ArK) programme is technically an assurance scheme rather than an insurance scheme, it has significantly expanded access to healthcare, particularly in rural areas.“Every year, we process around 32-35 lakh pre-authorisation requests (an advance approval granted by a health insurance or health coverage scheme that allows a hospital to provide cashless treatment to an eligible beneficiary). However, the actual number of beneficiaries is between 20 lakh and 25 lakh, as some requests are repeat admissions or multiple claims by the same patient,” the official said.
