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India Approves 'Sabka Bima - Sabki Raksha' Bill for Universal Health Coverage

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  Published in Business and Finance on Tuesday, December 16th 2025 at 0:37 GMT by Zee Business

Sabka Bima – Sabki Raksha: India’s All‑Inclusive Health Insurance Bill Gets the Green Light

The Ministry of Finance has taken a historic step towards universal health coverage by announcing the introduction of the “Sabka Bima – Sabki Raksha” bill in the Lok Sabha. The bill, which promises comprehensive insurance for every citizen, marks a significant policy shift in India’s approach to health care financing and is expected to reshape the country’s insurance landscape over the next decade.

The Vision Behind the Bill

The phrase Sabka Bima – Sabki Raksha translates to “Everyone’s Insurance – Everyone’s Protection.” It builds upon the momentum created by the 2018 Pradhan Mantri Jan Arogya Yojana (PMJAY), part of the larger Ayushman Bharat health initiative. While PMJAY provides coverage for hospitalization expenses, the new bill is designed to extend coverage to a broader spectrum of health services—including outpatient care, preventive treatments, and chronic disease management.

According to the finance minister, the bill is part of the government’s larger goal to achieve “Health for All” by the end of the decade, aligning with the Sustainable Development Goal (SDG) 3.8 on universal health coverage. By creating a legally binding framework, the government aims to ensure that insurance schemes are not only available but also equitable and sustainable.

Key Features of the Bill

1. Universal Coverage
   The bill mandates that all Indian residents, irrespective of age, gender, or income, are entitled to an insurance plan that covers a range of medical expenses. The coverage will be tailored to meet the needs of different demographic groups, including children, pregnant women, and senior citizens.

2. Integrated Health Benefit Package
   The proposed benefit package will encompass: - Inpatient and Outpatient Care: Hospitalization, surgeries, and day‑care procedures. - Preventive & Screening Services: Routine check‑ups, vaccinations, and early detection of non‑communicable diseases. - Chronic Disease Management: Diabetes, hypertension, and other long‑term conditions. - Mental Health Services: Counseling and psychiatric care, an area that has historically been under‑insured.

3. Risk‑Pooling and Capital Adequacy
   The bill introduces a mandatory risk‑pooling mechanism that requires insurers to maintain a reserve fund proportional to the population they serve. This is intended to prevent “adverse selection” and keep premiums affordable for lower‑income groups.

4. Regulatory Oversight and Consumer Protection
   A dedicated authority will be established to monitor insurer compliance, adjudicate disputes, and enforce transparency in premium pricing. The authority will also oversee claim settlements, ensuring timely reimbursement for beneficiaries.

5. Cross‑Sector Collaboration
   The bill encourages partnerships between public and private sectors, including public‑private partnerships (PPPs) in hospital infrastructure. This is designed to address capacity gaps in rural and underserved regions.

How It Builds on PMJAY

PMJAY, which initially covered hospitalization costs up to ₹5 lakh per family per year, has been a cornerstone of India’s public health system. The new bill extends this coverage to a much wider array of services. The government plans to integrate the two schemes, creating a seamless experience for beneficiaries. The Ministry of Health and Family Welfare (MOHFW) will coordinate with the Ministry of Finance to ensure that data sharing and operational logistics run smoothly.

In addition, the bill addresses some of the criticisms that have emerged around PMJAY—such as limited coverage for outpatient services and difficulties in claim processing. By embedding consumer rights into the bill, the government hopes to improve trust and uptake.

Economic and Social Implications

From an economic standpoint, the bill is expected to stimulate the insurance industry. By mandating coverage, insurers will need to expand their product lines and adapt risk models. The government anticipates a modest increase in premium contributions, but it argues that the long‑term savings in health care expenditure—through preventive care and early intervention—will offset these costs.

Socially, the bill seeks to reduce out‑of‑pocket expenses that can push families into poverty. According to the World Bank, health shocks are a leading cause of impoverishment in low‑ and middle‑income countries. By providing a safety net for all citizens, the bill aims to curb this cycle.

Stakeholder Reactions

Insurance Companies: Some private insurers have expressed concerns about the risk‑pooling requirements, which they fear could lead to higher capital costs. Others see the bill as an opportunity to tap into a larger, government‑backed market.

Public Health Advocates: Many NGOs and patient advocacy groups have welcomed the bill, citing its potential to bring equitable coverage to marginalized communities.

State Governments: While most state governments support the initiative, a few have raised questions about the fiscal burden of implementing the scheme at the local level.

Implementation Timeline

The bill will be introduced in the Lok Sabha in the next parliamentary session. If passed, a phased rollout is anticipated:

1. Phase 1 (Year 1‑2): Piloting in selected districts to refine the benefit package and regulatory mechanisms.
2. Phase 2 (Year 3‑5): Nationwide coverage, with continuous monitoring and adjustments.
3. Phase 3 (Year 6 and beyond): Expansion to include additional services like dental and eye care, and integration with digital health platforms.

The government has also committed to leveraging technology for enrollment, claim processing, and data analytics, ensuring that the system remains efficient and consumer‑friendly.

Looking Ahead

The introduction of the “Sabka Bima – Sabki Raksha” bill marks a pivotal moment in India’s journey toward universal health coverage. By providing a comprehensive, legally binding framework that spans the entire spectrum of health needs, the government is taking a decisive step toward reducing health inequities and safeguarding the well‑being of its population.

As the bill moves through Parliament, stakeholders will be closely watching its provisions, particularly those related to risk‑pooling and consumer protection. The outcome of this legislative effort will not only shape the future of health insurance in India but could also serve as a model for other emerging economies seeking to balance affordability, accessibility, and sustainability in their health systems.