Health Insurance for India’s Missing Middle – NITI Ayog
Health Insurance for India’s ‘Missing Middle’ - a comprehensive report, which brings out the gaps in the Healh insurance coverage across India, was released by NITI Aayog in October 2021.
Major Findings: India’s population is vulnerable to catastrophic spending, and impoverishment due to high Out of pocket expenditure, and it impacts all segments of the populationAbout two-thirds of the population seek treatment in the costlier private sector.
Missing Middle: At least 30% of the population, or 40 crore individuals are devoid of any financial protection for health. This is known as the missing middle. It contains multiple groups across all expenditure groups. It predominantly constitutes the self-employed (agriculture and non-agriculture) informal sector in rural areas, and a broad array of occupations – informal, semi-formal, and formal – in urban areas.
Rural Areas: Self-employed in agriculture constitutes the largest segment of the rural ‘missing middle’ with approximately 40% to 60% of the households. Second is the self- employed in non-agriculture, constituting around 20% of all household.
Urban Areas: Approximately 45% to 70% of households are engaged in managerial, professional, or technical occupations. The category of ‘managers, senior officials, and legislators’ constitutes the largest urban missing middle occupation segment with 25% to 45% of all household
