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Issue There are multiple small health insurance schemes throughout India. However, high out-of-pocket (OOP) expenditures, unaffordable and inequitable access to healthcare services still persist. In an attempt to address these issues and achieve Universal Health Coverage (UHC), India launched the healthcare scheme ‘Ayushman Bharat’ (“long live India”) in 2018. Description The Ayushman Bharat (AB) scheme has two components which include 1) transforming the existing primary healthcare centers (PHC) under the control of State Governments and 2) the National Health Protection Scheme (NHPS) also known as “ModiCare” - a health insurance. The scheme aims to transform nearly 150.000 PHCs to deliver comprehensive primary healthcare services across the country by 2022. NHPS covers the costs of almost all secondary and many tertiary care procedures of about 40% of the total Indian population. The coverage will be approximately €6.400 per year per beneficiary family; 60% of the costs are borne by the Centre and 40% by the States. Results Approximately €127 million have already been allocated by the Centre towards the AB scheme for the fiscal year 2018-19. Till date, around 29 million health insurance cards have been issued, approximately 1,8 million beneficiaries have been admitted and around 15.291 hospitals have been empaneled under NHPS. However, there is no data available validating the usage of the health services yet. Few Indian states are yet to implement the AB scheme. Lessons For the first time, attempts have been made to provide affordable healthcare services to the Indian population under a single common initiative. However, the AB scheme fails to cover outpatient health services, which are an important part of OOP expenses in India. Main message The effort to launch Ayushman Bharat in a big, democratic and diverse country like India has to be lauded, which not only aims to make healthcare services affordable but also aligns itself to the concept of UHC.

“Living long in India”– India’s progress towards Universal Health Coverage