Will Rajasthan's Flagship Chiranjeevi Health Scheme Give A Boost To Incumbent Congress?

“Vikas to kiya hai, toh wapas lana hai… (welfare has been done, so we need to bring him back),” says 50-year-old Jagdish Pawar, a florist who runs his business from the Sardarpura constituency of Jodhpur. Pawar was referring to hospital infrastructure and medical facilities brought in by the Ashok Gehlot-led Congress government that have played out well with the locals, in the run-up of the assembly elections.

With less than two weeks left for the state to go to polling, several welfare schemes announced by the ruling Congress in Rajasthan are being talked about immensely at the grassroots level and one of those is the flagship Chiranjeevi Swasthya Bima Yojana that provides up to Rs 25,00,000 health coverage to permanent residents of the state who come under the Social Economic and Caste Census (2011), NFSA card holders, contract workers in state governments, small-time farmers, and Covid-19 ex-gratia beneficiaries. Other beneficiaries of the scheme are required to pay an annual premium of Rs 850. 

The scheme which was launched in May 2021, initially provided a coverage of Rs 10,00,000 and it was hiked up to Rs 25,00,000 in February earlier this year. The newer provision was announced by Gehlot, who holds the finance portfolio, when he tabled the 2023-24 Budget in the state assembly. It was his last budget before the polls.

Recalling how one of the neighbours from his village, Barli, on the outskirts of Jodhpur, benefitted from the health scheme, Sairam, a tea seller says, “My neighbour’s daughter had a fall from a second-floor balcony and had to undergo immediate head surgery. We immediately reached out to a few local Congress workers who arranged for the necessary aid and she was brought to a government hospital in Jodhpur.” Sairam says that not only the treatment was done for free but a sum was also paid post-hospitalisation. “Keeping all these in mind, why should not we bring back Gehlot ji?” says Sairam in front of his customers in Gehlot’s constituency.

While announcing the scheme, Gehlot said the budget “wasn’t presented keeping elections in mind” and that he chose to go with the “theme of social security”. In fact, Gehlot had asserted that with the scheme, Rajasthan has evolved into a national model state for the health sector. He said that one day all other states and the Centre would also have to implement (similar schemes) and urged Prime Minister Narendra Modi to implement the Chiranjeevi Yojana throughout the country.

However, locals, who seem to sway towards the opposition allege that the Chiranjeevi scheme is nothing but an eye wash. “It would not have existed without Centre’s Ayushman Bharat Yojana (PMJAY) that had established the idea of a state and national-level health system,” says Balwant Singh, a local from Jodhpur.

Even though the scheme seems to have given a boost to Congress’s governance to perhaps be able to break the anti-incumbency, a study and research are perhaps required to substantiate the beneficence with data. In this context, Singh reminds us that there are places far across the state, where there is a complete lack of health infrastructure. 

A stark example of the same is seen in the village areas of Rajasthan’s westernmost district Barmer, where there is a lack of proper health facilities, forcing villagers to travel 200 km to Jodhpur for treatment. Earlier this year, during a dengue-like fever outbreak, local residents faced dire conditions, with many having to seek treatment in Jodhpur due to limited space in the district hospital. These issues might transform into matters of electoral concern, though caste and community politics still dominate the spotlight in the state.

Early this year, the scheme led to a controversy with the Right to Health Bill, 2022, which ran into rough waters when the private health sector protested the state’s free health check-up scheme. Several private hospitals have boycotted the State government’s health schemes, including the Chiranjeevi Yojana, and refused cashless treatment to patients in protest against the Bill. They reportedly turned away patients, forcing them to visit government hospitals to avail the scheme's benefits.

There are about 900 empanelled hospitals across the State providing treatment under the Chiranjeevi Yojana and an association of the agitating private health players believe that the Yojana would have a stifling effect on the private health infrastructure without any government compensation to make up for the expenses incurred. The private hospitals even appealed to Governor Kalraj Mishra demanding its withdrawal. However, the Bill, which was one of the promises of the Gehlot government during the 2018 assembly elections, was passed in March.

The Bill gives provision for emergency care in private hospitals without any prepayment, and if patients are unable to pay the bill, the government would reimburse on their behalf.