The Comprehensive Health Security Scheme (CHSS) that will offer up to Rs 5 lakh insurance cover to the whole of Kerala will roll out from May this year. This was announced by Finance Minister T M Thomas Isaac during his budget speech on January 31. “We are entering into the tender process of the insurance scheme,” the finance minister said. The CHSS will also use funds from the Centre's flagship insurance scheme Ayushman Bharat.
The finance minister said that the state's insurance coverage would be an improvement on Ayushman Bharat scheme, especially in terms of its spread. “Under Ayushman Bharat, the Centre provides assistance to 18 lakh families only. But already, the state covers 42 lakh families under the RSBY (Rashtriya Swasthya Bhim Yojana) scheme,” Isaac said.
Ayushman Bharat's attraction is the maximum coverage of Rs 5 lakh per family. Under the RSBY scheme the maximum entitlement is only Rs 30,000. The state government's plan is to make the scheme universal with the enhanced entitlement. Besides the 42 lakh families insured under the RSBY, 10 lakh families have ESI insurance. Another 10 lakh have their own health insurance. They will be automatically enrolled in the scheme. “The remaining 20 lakh families have the right to join this insurance-cum-assurance scheme by remitting their own premium. Thus this is a universal scheme ensuring health insurance to families in the state,” Isaac said.
Nonetheless, Isaac said that the premium fixed by the Centre would not be enough. For RSBY, which gives a maximum cover of only Rs 30,000, the premium is Rs 1,250 per person. As for Ayushman, with a maximum cover of Rs 5 lakh, it is Rs 1,100. “Moreover, the Centre will provide only 60 per cent of this,” Isaac said. He said for benefits worth Rs 5 lakh, the premium has to be more than Rs 8,000. According to the minister, the state will end up spending Rs 800-1000 crore for the scheme with the Centre contributing just Rs 100 crore.
Still, the government has decided to go ahead with the new scheme. Members of all the insured families will be provided treatment worth Rs 1 lakh from the insurance company. “Expenses above this, up to Rs 5 lakh, will be given to the hospitals concerned directly from the government,” Isaac said. The government will combine the RSBY and Karunya Benevolent Scheme under the new scheme. “Other schemes of the health department will also be combined with this,” Isaac added.
He said the complete revenue from Kerala Lottery will be set apart for this. During 2018-19, the revenue from lottery has shot up to over Rs 11,000 crore. The net revenue, after the operational costs, would be anywhere between Rs 3,000 crore to Rs 4,000 crore.