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JAY Ho: Ayushman Bharat's Jan Arogya Yojana (JAY) and Health Outcomes 293

These programs have also been able to target racial disparities in health care, with African American
and Hispanic children constituting 58 per cent of the children covered under these programs. Also,
5
the likelihood of financial insecurity, medical debt or bankruptcy is reduced if the families have access
to these insurance programs (Medicaid and CHIP). Therefore, medical insurance coverage under
6
Medicaid and CHIP allowed for greater financial stability alongside improving child’s educational
attainment and future earnings. The insurance coverage of the parents tends to be positively correlated
7
with children’s benefit as child’s health is directly influenced by the health of his parents, with healthy
parents leading to positive childhood developments. 8
The adoption of Seguro Popular (Popular Public Health Insurance Program) in Mexico, enabled
massive growth in insurance coverage across the country, becoming the second largest health
institution by coverage in few years (Urquieta-Salomon and Villarreal 2016. This program allowed
for a five times increase in the proportion of insured poor families (Frenk et al, 2006). Consequently,
the proportion of Mexican population with no insurance coverage remained very low, at 18 per cent
in 2015 (Doubova (2015)).
In 2001, Thailand became the first lower-middle income country to introduce universal health
coverage reforms, replacing the old means-tested health care for low income households with a
more comprehensive co-payment insurance scheme, called the ‘30 Baht Project’ (World Bank 2012).
9
The 30 Baht scheme was later replaced with UHC with no co-payment While these reforms were
criticised to a great extent, they proved popular among the poorer Thais, primarily in the rural areas.
10
As a result of its robust healthcare system, Thailand became the first Asian country to eliminate HIV
transmission from mother to child in 2016 (CNN 2016).

PM-JAY AND COVID-19

9.17. Two key facts are worth noting. First, as we discussed before, dialysis is a common
procedure availed under PM-JAY. Its use did not diminish at the onset of CoVID-19 or during
the lockdown (March-April 2020) even though we can observe a steep fall in claims under the
overall general medicine category in the same period. This highlights the users’ reliance on PM-
JAY or the life-saving dialysis procedure. Thus, the critical, life-saving health procedures such
as dialysis seem to have not been severely affected during the CoVID-19 pandemic. Figure 3a
presents the trends in the volume of pre-authorized claims starting July 2018.

5 Center on Budget and Policy Priorities, “Medicaid Works for Children.”
6 Brooks and Whitener, “Medicaid and CHIP 101.”
7 Center on Budget and Policy Priorities, “Medicaid Works for Children,” January 19, 2018, available at https://
www.cbpp.org/research/health/medicaid-works-for-children
8 Georgetown University Health Policy Institute Center for Children and Families, “Health Coverage for Parents
and Caregivers Helps Children” (Washington: 2017), available at https://ccf.georgetown.edu/wp-content/
uploads/2017/03/Covering-Parents-v2.pdf
9 Co-payment mechanism was abolished in 2008
10 The Universal Coverage Policy of Thailand: An Introduction Archived 2012-01-19 at the Wayback Machine