Premila’s Journey to Recovery
Living with Unbearable Pain
Premila, an 80-year-old woman from Madhya Pradesh, endured nearly two years of excruciating hip pain that severely restricted her mobility. Simple daily activities became monumental challenges as she could barely move without physical support. Her condition demanded immediate hip replacement surgery, but her health card coverage presented a significant obstacle—no nearby hospital in her state could provide the specialized treatment she desperately needed.
A Ray of Hope Through Healthcare Portability
“I felt helpless and thought I would have to live with this pain forever,” recalls Premila. “One morning, my son read in the newspaper that the Government of Rajasthan had started portability services under the MAA Yojana, allowing patients like me to get treatment in hospitals across Rajasthan regardless of their home state.”
This groundbreaking news transformed Premila’s outlook after months of despair and suffering. Her son immediately contacted Geentanjali Hospital in Udaipur, Rajasthan, and within a short period, she was admitted for treatment.
Successful Treatment and Recovery
Premila underwent a comprehensive left hip replacement surgery at the hospital, with the entire procedure conducted on a completely cashless basis. The medical staff provided exceptional care that made her feel welcomed and valued. “The doctors and nurses treated me with such kindness and respect that I never felt like I was away from home,” she shares. “Today, I can walk again without pain—something I thought was impossible just months ago.”
Understanding Healthcare Accessibility Challenges
The Healthcare Crisis in India
Millions of people across India face severe challenges in affording and accessing quality healthcare services. This widespread problem creates devastating financial hardship and vulnerability for countless families. Many households are forced to forego necessary medical care due to cost constraints or lack of accessible facilities, resulting in detrimental effects on their overall health and wellbeing.
Geographic and Economic Barriers
The healthcare accessibility crisis becomes particularly acute in rural and semi-urban areas, where specialized medical facilities are scarce or non-existent. Patients often must travel long distances to receive appropriate treatment, incurring additional expenses for transportation and accommodation while dealing with their medical conditions.
The Evolution of Ayushman Bharat
Launching Universal Health Coverage
In 2018, India launched the revolutionary Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) nationwide, marking a historic milestone in the country’s healthcare journey. This ambitious initiative aimed to provide comprehensive financial coverage for hospital-based services to vulnerable households across the entire nation.
Network of Healthcare Providers
The scheme operates through an extensive network of both public and private hospitals, ensuring that beneficiaries have access to quality medical services regardless of the facility type. This inclusive approach helps maximize coverage and accessibility for eligible populations.
MAA Yojana: Rajasthan’s Healthcare Innovation
State-Level Adaptation and Enhancement
The State of Rajasthan adapted the national scheme under the Mukhya Mantri Ayushman Arogya (MAA) Yojana, taking a significant leap forward in advancing universal health coverage (UHC). Rajasthan’s version offered one of India’s highest financial protection thresholds under the broader umbrella of AB PM-JAY, demonstrating the state’s commitment to comprehensive healthcare access.
Initial Limitations and Equity Concerns
Despite its widespread success and reach within Rajasthan, the MAA Yojana initially faced significant limitations. The benefits remained confined exclusively to Rajasthan’s residents, as the state had not adopted the portability function that facilitates the use of hospitals anywhere in India for AB PM-JAY beneficiaries.
The Border Problem
This restriction created substantial challenges for people living in neighboring states, often just a few kilometers from the Rajasthan border. These patients could not access Rajasthan’s superior network of hospitals, even when these facilities were the nearest or best-equipped options available. This situation created an unintended equity divide, leaving many patients without timely or affordable care due to purely administrative and geographic restrictions.
Breaking Barriers Through Portability
Recognition and Reform
Recognizing this critical gap in healthcare delivery, the Rajasthan State Health Assurance Agency (RSHAA), with valuable support from the World Health Organization (WHO) through the UHC Partnership, made the strategic decision to introduce the portability provision under the MAA Yojana and enhance overall benefits.
Transcending State Boundaries
This transformative reform removed a long-standing barrier to healthcare access and reflects the broader principle that the right to quality healthcare must be nationwide and transcend state boundaries. The portability provision embodies the fundamental belief that patient care should not be restricted by administrative divisions when better treatment options exist elsewhere.
Supporting Mobile Populations
The provision also has significant potential to support migrants, including internal migrants, enabling them to access essential medical services within Rajasthan regardless of their state of origin or residence.
Impact and Future Prospects
Remarkable Early Results
The portability provision officially launched in April 2025, and the results have been remarkable. Within the first eight months of implementation, an impressive 8,000 patients from outside Rajasthan have received treatment under the scheme, demonstrating the urgent need for such cross-border healthcare accessibility.
Global Partnership for Health
The UHC Partnership, which supported this initiative, operates in over 125 countries, representing more than 3 billion people worldwide. It receives support and funding from Belgium, Canada, the European Union, France, Germany, Ireland, Luxembourg, Japan, the United Kingdom of Great Britain and Northern Ireland, and WHO, demonstrating international commitment to universal health coverage.
A Model for Healthcare Equity
Premila’s story represents just one of thousands of success stories emerging from this innovative portability provision. Her journey from debilitating pain to restored mobility exemplifies how progressive healthcare policies can transform lives and promote genuine equity in healthcare access across India.
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