Ayushman for Senior Citizens: We will expand the Ayushman Bharat Yojana to cover Senior Citizens and provide them access to free and quality healthcare.

The 2024 Sankalp Patra makes this commitment under its own heading: "Ayushman for Senior Citizens: We will expand the Ayushman Bharat Yojana to cover Senior Citizens and provide them access to free and quality healthcare."

The promise runs to 2029 and the expansion is under way, so this entry does not grade delivery. What it does is record the condition of the machine the expansion is being bolted onto — because a new cohort of beneficiaries inherits whatever the existing enrolment and claims systems do well or badly.

The CAG's performance audit of PM-JAY, tabled on 8 August 2023, is the audited record of those systems. Its verdict on the scheme's value is unambiguous and belongs first: PM-JAY is "an ambitious and well-intentioned programme" which "has had a strong positive impact on the economically weaker sections of the society who need healthcare facilities." At the scale of 3.57 crore claims worth ₹42,433.57 crore settled by November 2022, that impact is not a figure of speech.

Its findings on the plumbing are the reason this fact-check exists. On enrolment, "7.87 crore beneficiary households were registered, constituting 73 per cent of the targeted households of 10.74 crore (November 2022)", and only 2.08 crore of those were identified from the eligibility database the guidelines prescribe. The control designed to keep the wrong people out was not in use: applications "were approved or rejected irrespective of the match confidence score", which the audit found "was not applied during the approval/rejection process" at all.

What followed was a beneficiary database with "invalid names, unrealistic date of birth, duplicate PMJAY IDs, unrealistic size of family members in a household", including "4761 registrations… against seven Aadhaar numbers" in Tamil Nadu and up to 7,49,820 beneficiaries registered against a single mobile number. In six states and union territories ineligible households drew benefits, costing between ₹0.12 lakh in Chandigarh and ₹22.44 crore in Tamil Nadu.

On the claims side, the most striking finding concerns patients who had died. The audit had flagged in July 2020 that the transaction system was accepting fresh treatment requests for people already recorded dead; the National Health Authority said checks were in place from April 2020. The audit then found that "patients earlier shown as 'died' in TMS continued to avail treatment under the Scheme" — 88,760 patients recorded dead, 2,14,923 claims shown as paid for their fresh treatment, and 3,903 of those, worth ₹6.97 crore, actually paid to hospitals.

And in four states, the scheme's core promise failed at the counter: beneficiaries "were charged for their treatment in empanelled EHCPs resulting in increase in out-of-pocket expenditure" — 13,418 of them in Meghalaya alone.

None of this is a judgement on the senior-citizen expansion, which the audit predates. It is the answer to a different and useful question: if the same enrolment and claims systems now take on a new cohort defined purely by age, what is known about how well those systems distinguish the eligible from the ineligible, and the living from the dead. Our verdict is unverifiable, because the promise is not yet due — and the audited condition of the scheme it expands is on the record above.