Parliament Question: Out-of-Pocket Expenditure on Health in Kerala

GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO. 5712 TOBE ANSWERED ON27TH MARCH, 2026 OUT-OF-POCKETEXPENDITURE ONHEALTH IN KERALA 5712SHRISHAFIPARAMBIL: Will the Minister of HEALTHANDFAMILYWELFARE be pleased tostate: (a) the percentage and per capita Out-Of-Pocket Expenditure (OOPE) on health in the State of Kerala during the last ten years, year-wise; (b) the comparative data on out-of-pocket health expenditure in other States and Union Territories during the same period; (c) whether Kerala’s OOPE ishigher or lower thanthe nationalaverage andif so, the reasons thereof; (d) the major components contributing to out-of-pocket expenditure in Kerala including medicines,diagnostics, hospitalization andoutpatientcare;and (e) the steps taken by the Union Government to reduce the financial burden on households, including the expansion of Ayushman Bharat and other health insurance schemes in the said State? ANSWER THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH AND FAMILY WELFARE (SMT.ANUPRIYAPATEL) (a) to (c): As per latest available National Health Accounts estimates, the per capita Out-Of- Pocket Expenditure (OOPE) and OOPE share in Total Health Expenditure (THE) for States, includingKerala,for FY2014-15 toFY2021-22 isplacedat Annexure. (d) As per the NHAestimates for FY2021-22, major components of OOPE at all India level is available at public domain and the URL is https://mohfw.gov.in/sites/default/files/NHA%202021-22_up.pdf {Table A 3 - Current Health Expenditure (2021-22) by Healthcare Functions and Health Financing Schemes (HCxHF matrix)}. (e) The Government is committed to provide good quality health care services through increasing access, increasing affordability by lowering the cost of healthcare delivery and equity, including those in rural areas leading to reduce the financial burden on households across States/UTs including Kerala. Towards this, various schemes such as National Health Mission, Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission, Pradhan Mantri Swasthya Suraksha Yojana, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, among othersare beingimplemented through DoHFW.In order to strengthen public healthcare delivery, various measures are undertaken by Government of India. Under the NHM, the Government has taken many steps towards universal health coverage by supporting the State Governments in providing accessible and affordable healthcare to people. As per AAM portal, more than 1.8 lakh AAMs, including 7,200 approx. in Kerala, have been established to deliver the expanded range of comprehensive primary healthcare services that includes preventive, promotive, curative, palliativeandrehabilitative services. Further, under PM- Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), focus is ondeveloping capacitiesof healthsystems andinstitutions across the continuum of care at all levels, primary, secondary and tertiary, to prepare health systems in responding effectively to the current andfuture pandemics /disasters. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) aims to provide health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to more than 12 crore families constituting the economically vulnerable bottom 40% of India’s population.States/UTsimplementingAB-PMJAYhave furtherexpandedthebeneficiarybase, at their own cost. Additionally, the scheme has beenexpanded tocover6crore senior citizens of age 70 years and above belonging to 4.5 crore families irrespective of their socio- economic status under AB-PMJAY with Vay Vandana Card. As on 28th February 2026, a total of 11.69 crore hospital admissions amounting to Rs. 1.73 lakh crore have been authorized under the scheme since its launch in September 2018, including 78.35 lakh hospital admissions amountingtoRs. 9,525.17crore inKerala. Besides, quality generic medicines are made available at affordable prices to all under Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) in collaboration with the State Governments. Affordable Medicines and Reliable Implants for Treatment (AMRIT) Pharmacystores have been set upinsome hospitals/institutions. *****Annexurereferred to inreply to Part(a) to (c)of Lok SabhaUnstarred QuestionNo. 5712 forreply on27.03.2026 ANNEXURE Statementshowing percapitaOut-Of-Pocket Expenditure (OOPE)andOOPEsharein TotalHealth Expenditure(THE) forStatesincluding Kerala S. 2014-15 2015-16 2016-17 2017-18 2018-19 2019-20 2020-21 2021-22 States No A B A B A B A B A B A B A B A B 1 Andhra Pradesh 2,901 78.0 3,097 74.7 3,322 72.2 3,102 67.0 3,140 63.2 3,254 63.6 3,576 58.8 3,834 52.0 2 Assam 1,293 63.1 1,315 55.1 1,378 53.8 883 35.9 949 36.7 998 34.9 1,064 33.2 1,180 27.6 3 Bihar 1,685 82.3 1,776 79.9 1,830 77.6 808 58.2 811 53.5 863 54.3 911 50.2 984 41.3 4 Chhattisgarh 1,838 58.3 1,971 58.4 2,040 55.9 1,186 38.8 1,175 38.3 1,253 36.7 1,356 33.9 1,419 29.2 5 Gujarat 1,626 53.1 1,681 50.4 1,781 48.1 1,551 43.9 1,606 40.7 1,687 40.8 1,811 40.0 1,942 35.0 6 Haryana 2,376 62.5 2,427 59.5 2,564 56.6 2,181 50.4 2,193 47.2 2,358 45.5 2,510 42.2 2,647 37.5 7 HimachalPradesh 2,274 50.0 2,437 49.5 2,550 46.4 3,220 49.2 3,180 45.8 3,397 46.0 3,591 45.0 3,844 39.6 8 Jammu & Kashmir 1,971 60.7 2,138 56.0 2,311 58.5 1,332 42.8 1,363 44.9 1,450 46.6 1,443 31.8 1,581 25.9 9 Jharkhand 1,436 71.7 1,494 66.3 1,527 66.0 1,852 68.0 1,915 63.9 2,000 64.7 2,108 61.8 2,243 47.5 10 Karnataka 2,282 52.2 2,447 49.6 2,548 49.2 1,549 34.2 1,625 33.3 1,722 31.8 1,810 30.3 1,933 25.4 11 Kerala 5,023 73.9 5,111 71.3 5,419 67.0 6,363 68.7 6,772 68.6 7,206 67.9 7,669 65.7 7,889 59.1 12 Madhya Pradesh 1,808 72.0 1,879 70.1 1,944 68.9 1,364 56.3 1,409 55.7 1,500 53.0 1,603 53.0 1,739 43.3 13 Maharashtra 2,684 59.6 2,788 58.9 2,956 56.7 2,570 49.1 2,644 48.4 2,779 44.1 2,950 42.4 3,184 38.1 14 Odisha 2,518 73.6 2,693 71.5 2,796 68.9 1,750 55.9 1,750 53.2 1,926 53.4 2,002 44.6 2,133 37.1 15 Punjab 4,138 79.3 4,332 77.4 4,608 77.3 2,935 69.4 3,065 65.5 3,313 64.7 3,470 62.3 3,668 57.2 16 Rajasthan 1,740 59.1 1,818 56.4 1,934 56.7 1,688 49.6 1,745 44.9 1,856 47.4 1,896 42.8 2,048 37.1 17 Tamil Nadu 2,724 66.4 2,829 65.2 2,938 62.1 1,817 45.9 1,909 44.3 2,034 44.2 2,191 36.9 2,280 34.6 18 Uttar Pradesh 2,396 78.3 2,469 76.5 2,597 74.8 2,393 72.6 2,481 71.3 2,670 71.8 2,775 70.2 3,014 63.7 19 Uttarakhand 2,545 60.1 2,391 61.2 2,498 62.1 1,237 41.7 1,216 35.5 1,317 35.8 1,437 33.4 1,560 26.9 20 Telangana 2,834 62.1 3,054 57.9 NA NA 2,120 49.7 1,982 48.0 2,125 41.6 2,234 39.8 2,449 37.6 21 West Bengal NA NA NA NA 3,169 74.1 3,115 69.8 3,208 68.7 3,425 67.1 3,648 65.1 4,010 58.3 22 Al India 2,394 62.6 2,494 60.6 2,570 58.7 2,097 48.8 2,155 48.2 2,289 47.1 2,415 44.4 2,600 39.4 A=OOPEPerCapita(inRs.), B=OOPE%THE(in%)