80% Of Indians With Disabilities Remain Uninsured, Need Inclusion Under Ayushman Bharat: Report

More than 80 per cent of Indians with disabilities remain uninsured, and over half of those who apply are often rejected without explanation despite legal safeguards meant to ensure equal access to health coverage, a new white paper released on Thursday has found. The report, titled “Inclusive Health Coverage for All: Disability, Discrimination and Health Insurance in India”, was launched by the National Centre for Promotion of Employment for Disabled People (NCPEDP) at a roundtable attended by policymakers, insurers, and disability rights advocates.

Drawing on a nationwide survey of over 5,000 persons with disabilities across 34 states and union territories, the study warns that “deep systemic inequities” continue to block nearly 16 crore disabled Indians from both public and private insurance schemes.

According to the findings, 80 per cent of respondents had no health insurance, while 53 per cent of those who applied said their applications were rejected.

Many reported being turned away solely because of their disability or pre-existing conditions, with particularly high denial rates among persons with autism, psychosocial and intellectual disabilities, and blood disorders such as thalassemia.

The report noted that these practices persist despite constitutional protections, the Rights of Persons with Disabilities Act, 2016, and repeated directives from the Insurance Regulatory and Development Authority of India (IRDAI).

Researchers also flagged unaffordable premiums, inaccessible digital platforms, and a widespread lack of awareness about available schemes as major barriers to coverage.

Speaking at the launch, Manmeet Nanda, Additional Secretary, Ministry of Social Justice and Empowerment, said the government was working to strengthen assistive technology and improve coordination across ministries.

“IRDAI’s role, along with the Ministry of Health and Family Welfare and the Department of Empowerment of Persons with Disabilities, needs to be very strongly converged and coordinated because this is not a single ministry’s game,” she said, adding that insurers could be mandated to meet annual disability coverage targets monitored through digital dashboards.

She also offered to integrate the Unique Disability ID database with insurance processes to track rejections and streamline access.

Calling the findings a “moral and constitutional challenge”, NCPEDP Executive Director Arman Ali said the continued exclusion of persons with disabilities from affordable insurance “is more than a systemic failure; it is a violation of rights”.

“Even as the government expands Ayushman Bharat (PM-JAY) to cover all senior citizens aged 70 and above, persons with disabilities remain conspicuously excluded despite facing equal, if not greater, health vulnerabilities,” Ali said.

“There is no principled or policy justification for this gap… India cannot be burdened with the generational ‘cost of exclusion’ of people with disabilities,” he added.

The white paper recommended immediate inclusion of all persons with disabilities under Ayushman Bharat without age or income criteria, aligning with the government’s 2024 expansion for senior citizens.

Other key proposals include enhanced insurance coverage for mental health, rehabilitation and assistive technologies, the creation of a dedicated Disability Inclusion Committee within IRDAI, standardised and non-discriminatory premiums across private insurers, and mandatory accessibility in all insurance processes.

It also urged expanded awareness programmes for insurers and healthcare staff to ensure disability-sensitive service delivery.