Ayushman Bharat at a Crossroads — Odisha's Big Leap, National Questions Linge

On April 11, Odisha will see a milestone in its healthcare history. Union Health Minister J.P. Nadda will formally launch the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY) in the state, promising free healthcare to more than 3.5 crore citizens. The scheme, integrating with the already existing Gopabandhu Jan Arogya Yojana (GJAY), marks a bold initiative to cover 86% of the state's population under medical coverage.

And yet, as Odisha gets ready to celebrate this move towards healthcare inclusion, a sharply contrasting narrative is unfolding elsewhere in the nation—one that casts a long shadow over the credibility and governance of the very same scheme.

Only days prior to the Odisha launch, the Enforcement Directorate (ED) conducted a wide-ranging operation in Jharkhand, West Bengal, Uttar Pradesh, and Delhi, raiding 21 premises in relation to an alleged money-laundering racket within the Ayushman Bharat system. At the center of the probe are three third-party administrators (TPAs) — MDIndia, Medi Assist, and Safeway Insurance — whose function was to simplify services, not circumvent them.

The charges are serious. Fake treatments, doctored records, and even instances of dead patients "receiving" treatment have emerged, partly thanks to a scathing Comptroller and Auditor General (CAG) report. What was conceived as India's response to universal health coverage is now grappling with the painful reality of gaps in implementation and systemic weaknesses.

The contrast between Odisha's festive rollout and the ED's crackdown elsewhere is interesting. It begs the question: Can a scheme aimed at empowering the poor live with weak accountability?

To be sure, the vision of Ayushman Bharat is still profoundly moving. In Odisha, for instance, where much of the population lies beyond the reach of private health care, the scheme guarantees not only affordability but dignity in gaining access to life-saving services. A family cover of ₹5 lakh a year — and a similar amount set aside for women — is no trifling measure. If implemented properly, it has the potential to fill long-standing gaps in the healthcare system.

But sight alone won't do.

The fact itself that Jharkhand's highest functionaries, including those of the State Arogya Society, are on the watchlist indicates institutional fissures. When third-party go-betweens, left in charge of the well-being of millions, are accused of diverting funds under ghost patients and falsified bills, the harm goes beyond figures—it undercuts public confidence.

So what can Odisha learn from this juxtaposition?

Firstly, transparency must be non-negotiable. Every empaneled hospital, insurance handler, and data operator should be under regular audit. Secondly, states must not treat implementation as a box-ticking exercise. Localized corruption often thrives in administrative apathy—Odisha must ensure that its converged model with GJAY does not become a bureaucratic juggernaut prone to manipulation.

Lastly, there must be citizen awareness. Whether Ayushman Bharat succeeds in Odisha will not only rely on rollout ceremonies and political showmanship, but on whether or not people actually know their entitlements under the scheme and how to claim them.

While one region of India greets a new era of public health, another recalls why vigilance is as necessary as vision. Ayushman Bharat stands at a fork in the road today—Odisha has to ensure that its path ahead doesn't trudge down the same pitfalls that threaten to undermine its promise elsewhere.