The government is of the view that to achieve the vision of Insurance for All, more concentrated steps need to be taken to drive health insurance penetration and keep it affordable.
According to a recent report by the National Insurance Agency, over 400 million individuals, or about a third of the population, lack health insurance due to lower penetration, coverage inadequacy and rising healthcare costs.
«There are various challenges and opportunities, such as standardisation of treatment costs and settling health claims, that can be addressed by a sectoral regulator in the health insurance segment,» said one of the officials aware of the developments.
Another official said that the Department of Health and Family Welfare under the Ministry of Health is now expected to call a meeting of all stakeholders, including insurance companies, to thrash out a detailed plan and the role of a possible health regulator.
«A health regulator can further broaden the scope of the national Health Claims Exchange and can be entrusted with more powers to function like an industry watchdog,» said another official, clarifying that some of these are preliminary suggestions.
In January 2019, the government had reconstituted the National Health Agency as the National Health Authority (NHA), responsible for implementing India's flagship public health insurance/assurance scheme Ayushman Bharat.
The Insurance Regulatory and Development Authority of India (IRDAI) regulates insurers that provide health cover among other products.
The pricing of health insurance products is currently market-determined but there is wide variance across insurers in policy terms and claim restrictions and limits. A health regulator can help bring about some