A report by NITI Ayog said that about 7% of India’s population – about ten crore people – have been pushed into poverty annually due to healthcare expenses alone.

Amidst rising healthcare costs and the evolving landscape of health insurance and government schemes in India, understanding how households finance hospitalisation is crucial for policy development. This survey investigates the effectiveness of existing healthcare financing mechanisms and highlights areas where additional support may be needed.

The rapid survey covered 6,755 respondents across 421 out of India 543 parliamentary constituencies and anchored to population weights calculated from the National Family Health Survey (NFHS) to generate estimates representative of India

29% of the population rely on government health schemes to cover catastrophic health expenses, highlighting the crucial role of government assistance in creating access to healthcare. However, this also underscores the gaps in coverage, as many still face significant financial strain— 53% of the population still bear out-of-pocket health expenditure. Meanwhile, a smaller but considerable 19% rely on employer or private insurance to cover their healthcare costs.

Our data also reveals stark disparities across economic groups:

• The poorest are most likely to shoulder out-of-pocket health expenditure—those who do not own any vehicle (60%) are more likely to pay out of pocket than those who own a scooter or bike (48%), or a car (40%)
• Wealthier populations are less likely to shoulder out-of-pocket expenses due to better access to private and employer-sponsored insurance.
• Further, the share of those accessing government health schemes is quite similar across economic classes. This need to cater to a broad swathe of the population, combined inefficiencies in the execution of PM-JAY, make it difficult for the most vulnerable to access healthcare.