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Congress MP Shashi Tharoor has urged the Centre to revisit the funding pattern under Ayushman Vay Vandana, saying that the existing 60:40 Centre-State arrangement could place a disproportionate financial burden on states with ageing populations, particularly Keralam.
Tharoor raised the issue under Rule 377 in the Lok Sabha. In a post on X, he said that his submission was laid on the Table of the House on Monday and called for a financing mechanism that takes demographic differences among states into account. "Between disruptions: My submission under Rule 377 was laid on the Table of the House yesterday," Tharoor said in his tweet. He said that the Ayushman Vay Vandana scheme, which extends Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) health insurance coverage to senior citizens aged 70 years and above, continues to operate under the existing 60:40 Centre-State funding pattern. According to Tharoor's submission, central financial assistance is also subject to a prescribed per-beneficiary-family ceiling. He argued that states have to bear expenditure beyond the prescribed limit. Tharoor said that this arrangement could create a greater fiscal burden for states where the proportion of elderly citizens is higher, as senior citizens generally require more frequent and costly medical care. "This concern is particularly acute for Keralam, which has the country's highest proportion of elderly citizens," he said in his social media post. He urged the Union Finance Minister to reconsider the existing funding mechanism and develop a system that adequately accounts for demographic differences between states. The Congress MP said that such a mechanism should ensure that states with ageing populations are not required to shoulder a disproportionate share of the financial burden while implementing the health initiative. The Centre expanded AB-PMJAY in October 2024 to provide health coverage of Rs 5 lakh per year to all senior citizens aged 70 years and above, irrespective of their socio-economic status. The expansion covers about six crore senior citizens from 4.5 crore families. According to the Ministry of Health and Family Welfare, as of December 31, 2025, more than 96.73 lakh Ayushman Vay Vandana cards had been created across states and Union Territories, while 10.33 lakh hospital admissions worth Rs 2,154.37 crore had been authorised under the scheme. He also highlighted the need to account for the higher healthcare utilisation associated with ageing populations while determining the financial responsibilities of the Centre and states. (ANI)
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