Parliament Question: Out-of-Pocket Expenditure on Healthcare

GOVERNMENTOFINDIA MINISTRYOFHEALTH AND FAMILYWELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE LOK SABHA UNSTARREDQUESTION NO. 3415 TO BE ANSWERED ON07THAUGUST, 2026 OUT-OF-POCKETEXPENDITURE ON HEALTHCARE 3415.ADVGOWAALKAGADAPADAVI: Will the Minister of HEALTHANDFAMILYWELFARE be pleased tostate: (a) the definition of Out-of-Pocket Expenditure (OOPE) on health care incurred by households across the country, State/UT-wise; (b) the details of OOPE on healthcare incurred per household in the country during the last five years, State/UT-wise; and (c) the steps taken or proposed tobe takenbythe Government toreduce OOPE onhealthcareby households? ANSWER THE MINISTEROFSTATE IN THE MINISTRYOFHEALTH AND FAMILY WELFARE (SMT.ANUPRIYAPATEL) (a) As per National Health Accounts (NHA), the definition of Household Out-of-Pocket Expenditure (OOPE) is the expenditure paid by the household/individuals at the point of receiving healthcare services. These include all expenditures on inpatient care, outpatient care, childbirth, antenatal care (ANC), postnatal care (PNC), family planning devices, therapeutic appliances, expenditure on patient's transportation, immunisation, over the counter drugs and other medical expenditures (e.g., blood, oxygen, etc.); and are net of reimbursementsof anynature (insurance/philanthropic donationsetc.). (b) National Health Accounts Estimates for India published by Ministry of Health and Family Welfare do not maintain data on OOPE on healthcare incurred per household in the country. However, as per the available data from NHA Estimates, Per Capita OOPE incurred on healthcare inthe country during the last five yearsisasbelow: Year 2018-19 2019-20 2020-21 2021-22 2022-23 Per capita OOPE in (Rs.) at 2,155 2,289 2,415 2,600 2,767 current prices Further, State-wise detailsof percapita Out-of-PocketExpenditureare placedat annexure.(c) Ministry of HealthandFamily Welfare(MoHFW) supplementsthe efforts of the Statesand Union Territories (UTs) in expanding affordable healthcare services and strengthening healthcare infrastructure across the country, through various Centrally Sponsored Schemes and Central Sector Schemes. Towards this end, MoHFW is implementing schemes such as National Health Mission (NHM), Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), Pradhan Mantri- Ayushman Bharat Health Infrastructure Mission (PM- ABHIM), PradhanMantri Swasthya Suraksha Yojana(PMSSY). 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. 1.87 lakh Ayushman Arogya Mandir (AAM) have been operationalized across the country to deliver the expanded range of comprehensive primary healthcare services that include preventive, promotive, curative, palliative and rehabilitative services. These include reproductive and child healthcare services, communicable and non-communicable diseases, anda wide arrayof otherhealth concerns. National Free Drugs Service Initiative and Free Diagnostics Service Initiative have been rolled out to ensure availability of essential drugs anddiagnostic facilities,and reduce Out- of-Pocket Expenditure of the patients visiting public health facilities. This includes financial support to States/UTs for 113 drugs at AAM-Sub Health Centres, 179 at AAM- Primary Health Centres, 301 at Community Health Centres, 318 at Sub- District Hospitals and 381 at District Hospitals. 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 up insome hospitals/institutions. In addition, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) provides health cover of ₹5 lakhsper family per yearfor secondary andtertiary care hospitalization to more than 12 crore families constituting the economically vulnerable bottom 40% of India’s population. States/UTs implementing AB PM-JAY have further expanded the beneficiary base, at their own cost. Further, the scheme hasbeen expandedto cover6 crore senior citizens of age 70 years and above belonging to 4.5 crore families irrespective of theirsocio- economic status underAB PM-JAYwith VayVandanaCard. ***ANNEXURE Annexure referred to inreply to part(b)of Lok SabhaUnstarred QuestionNo. 3415 for answeron07.08.2026 Statewise PerCapitaOut-of-PocketExpenditure (OOPE) (in Rs.) 2019-20 2020-21 2021-22 2022-23 S.No State 2018-19 998 1064 1180 1237 1 Assam 949 Andhra Pradesh 3140 3254 3576 3834 4117 2 Bihar 811 863 911 984 1043 3 Chhattisgarh 1175 1253 1356 1419 1475 4 Gujarat 1606 1687 1811 1942 2080 5 Haryana 2193 2358 2510 2647 2923 6 Jammu andKashmir 1363 1450 1443 1581 1701 7 Jharkhand 1915 2000 2108 2243 2394 8 Karnataka 1625 1722 1810 1933 2049 9 Kerala 6772 7206 7669 7889 8388 10 Madhya Pradesh 1409 1500 1603 1739 1842 11 Maharashtra 2644 2779 2950 3184 3381 12 Odisha 1750 1926 2002 2133 2245 13 Punjab 3065 3313 3470 3668 3829 14 Rajasthan 1745 1856 1896 2048 2178 15 Tamil Nadu 1909 2034 2191 2280 2448 16 Uttar Pradesh 2481 2670 2775 3014 3219 17 Uttarakhand 1216 1317 1437 1560 1593 18 West Bengal 3208 3425 3648 4010 4183 19 Telangana 1982 2125 2234 2449 2697 20 HimachalPradesh 3180 3397 3591 3844 4047 21 Source:NationalHealthAccountsEstimates2018,2019,2020,2021,2022. Note: 1. The survey used in the estimates includes the 75th round Health and Morbidity Survey by the National Sample Survey Office (July 2017- June 2018) for computing Out-of-Pocket Expenditure (OOPE) and the survey on Health expenditure (2013-14) by Enterprises by Public Health Foundation of India and Annual Survey of Unincorporated Sector Enterprises (ASUSE) 2022-23 & 2023-24 for health expenditurebyNGOs/NPISH. Expenditurescomputedfromthesesurveysareusedforarrivingathealth accounts estimates at the National level. However, when computing health accounts estimates/indicators at the sub-national level, especially for Union Territories, Small States, and the North-Eastern States, the valuesarenotsignificantduetothesmallsamplesizeadoptedinthesurveyforthese regions.