Centre to integrate ESIC with Ayushman Bharat

The Union government is working to integrate healthcare delivery offered by the state-run Employees’ State Insurance Corporation (ESIC) with the Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana (AB-PMJAY), a cashless hospitalisation scheme, apart from setting up 20 new medical colleges to expand facilities for low-wage workers.

ESIC, a social-security organisation, provides critical healthcare services to the poorest sections among organised-sector workers, including for hospital admissions without expenditure limits, outpatient services, sickness allowances and maternity benefits.

Under the expansion drive, ESIC’s coverage was recently extended to 15 additional districts, labour minister Mansukh Mandaviya told HT. With this, the organisation now covers 689 districts in the country, of which 586 are fully covered.

ESIC has “approved in-principle” for 10 new ESIC medical colleges to be set up in Mumbai’s Andheri, Delhi’s Basaidarapur, Guwahati, Indore, Jaipur, Ludhiana, Naroda-Bapunagar in Gujarat, Noida, Varanasi and Ranchi.

“The approval for another 10 medical colleges is in the pipeline,” the minister said, adding that the ESIC’s integration with Ayushman Bharat will create “significant capacity” to cover workers across the country.

ESIC, set up under the Employees’ State Insurance Act 1948, covers all workers with monthly salaries up to a ceiling of ₹21000 and currently includes 30.72 million beneficiaries.

Once the integration is complete, ESIC will get access to a network of about 24000 hospitals empanelled under Ayushman Bharat, a public health insurance scheme which covers hospitalisation expenses of up to ₹5 lakh a year to eligible households. ESIC will continue fund the hospital bills as usual.

ESIC currently runs 165 hospitals countrywide, including medical colleges, and chain of 1574 dispensaries, not sufficient to cover workers in all districts of the country.

Public health spending, although on an increasing trend, is still below the national target of 2.5% of gross domestic product or GDP and stands at about 1.9%, according to the government’s Economy Survey 2024-25.

“Expanding ESIC is a welcome move but lot of districts are still not covered or partially covered. Quality of health services remains a big issue, along with long queues. In the past we have demanded one full-fledged hospital in every district. There is also the shortage of dispensaries,” said G Sanjeeva Reddy, a leader of the Indian National Trade Union Congress.”