• S.Bharathi
• Dr.M.Raju
• Dr.D.Gopalswamy

Health insurance plays an important role in protecting people from ruining out-of–pocket (OOP) payments and improving access to medical services. In India, the health insurance sector has undergone significant transformation over the past two decades due to regulatory reforms, increased private sector participation and the introduction of large scale government funded insurance schemes. This study examines the evolution of health insurance in India by analysing policy developments, market trends and the socio-economic determinants of insurance coverage. The research employs a mixed analytical approach combining descriptive statistical analysis with econometric modeling. Secondary data were obtained from the Insurance Regulatory and Development Authority of India (IRDAI), National Sample Survey (NSS) and other published sources. Binary choice models are used to identify the determinants of health insurance enrollment, while policy impacts are discussed using quasi-experimental approach i.e. difference-in-differences models. The results indicate a substantial increase in health insurance coverage, rising from approximately 10 percent of the population in 2005 to nearly 37 percent in 2022. The expansion accelerated significantly following the implementation of Ayushman Bharat–Pradhan Mantri Jan Arogya Yojana (PM-JAY). Empirical evidence suggests that income, education, employment status and urban residence are key determinants of insurance participation. Furthermore, government-sponsored insurance schemes have contributed to increased healthcare utilization and reduced out-of-pocket expenditure among beneficiary households. Despite these improvements, challenges related to affordability, awareness and regional disparities persist. The study concludes that strengthening regulatory frameworks, expanding coverage among informal sector workers and integrating insurance schemes with broader healthcare reforms are essential for advancing universal health coverage in India.

Health Insurance in India, Ayushman Bharat (PM-JAY), Health Financing, Insurance Coverage, Out-of-Pocket Expenditure, Econometric Analysis

"HEALTH INSURANCE IN INDIA: EVOLUTION, POLICY TRANSFORMATION AND ECONOMETRIC INSIGHTS", International Journal of Emerging Technologies and Innovative Research (www.jetir.org), ISSN:2349-5162, Vol.13, Issue 3, page no.e9-e21, March-2026, Available :http://www.jetir.org/papers/JETIR2603402.pdf

"HEALTH INSURANCE IN INDIA: EVOLUTION, POLICY TRANSFORMATION AND ECONOMETRIC INSIGHTS", International Journal of Emerging Technologies and Innovative Research (www.jetir.org | UGC and issn Approved), ISSN:2349-5162, Vol.13, Issue 3, page no. ppe9-e21, March-2026, Available at : http://www.jetir.org/papers/JETIR2603402.pdf