Manipur Faces Health Emergency as Private Hospitals Pull Out of PMJAY

The sudden halt of the Pradhan Mantri Jan Arogya Yojana (PMJAY) services in private hospitals across Manipur is a crisis that exposes the fragility of healthcare access in one of India’s most vulnerable states. 

This decision, driven by the non-reimbursement of pending PMJAY bills, threatens to unravel the lifeline that this flagship health assurance scheme has provided to millions of impoverished families. The government must act swiftly to clear these dues and restore services, as the suspension risks plunging Manipur’s already struggling population into deeper despair.

Manipur, with staggering poverty rate of 36.8 percent—among the highest in the nation—and a per capita income trailing far behind the national average, its people have long grappled with systemic economic challenges. Recent unrest has only deepened this crisis, shattering livelihoods, inflating prices, and crippling the informal sector that forms the backbone of the state’s economy.

In this fragile context, PMJAY, a flagship initiative under Ayushman Bharat, has been a lifeline, offering up to Rs 5 lakh per family annually for critical hospitalization. For Manipur’s poorest, particularly those reliant on life-saving treatments like dialysis, PMJAY is not just a scheme—it is a matter of survival. Yet, private hospitals in Manipur, pushed to the brink by the state government’s failure to clear long-pending reimbursement dues, have announced a temporary suspension of free PMJAY services starting August 16, 2025. This crisis, mirrored in states like Haryana, Jammu and Kashmir, and Rajasthan, is not merely a bureaucratic failure—it is a profound betrayal of India’s most vulnerable citizens, with life-and-death consequences.

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In Haryana, the Rs 490 crore in unpaid dues represents a staggering failure of governance. The state’s inability to allocate adequate budgets for PMJAY has left 1.8 crore beneficiaries in limbo. Similar stories in Jammu and Kashmir and Rajasthan point to a broader pattern of neglect. The central government, which oversees Ayushman Bharat, must share the blame for failing to ensure accountability and coordination with state authorities. The deaths of kidney patients in Manipur’s relief camps and the looming healthcare crisis in Haryana are stark reminders of what is at stake. These are not abstract statistics but real people—mothers, fathers, siblings—who are suffering because the system has failed them.

On July 30, 2025, the Association of Healthcare Providers of India (AHPI), Manipur Chapter, issued a stark ultimatum: private hospitals will halt free PMJAY services unless the state government settles outstanding dues. This decision, born of financial desperation, exposes the immense strain on private healthcare providers who have been a cornerstone of Manipur’s overstretched health system. Dr. Palin Khundongbam, AHPI Manipur’s president, and Dr. James Elangbam, its secretary, issued a joint statement explaining that while private hospitals have supported the state’s health infrastructure despite repeated financial setbacks, continuing free services without timely reimbursements has become “increasingly unfeasible.” During the suspension, treatments will be charged at standard rates, with the promise of refunds to eligible PMJAY beneficiaries once dues are cleared. The association expressed deep regret, urging the public to understand their predicament and appealing to authorities for swift resolution.

At present, Manipur has 25 hospitals empanelled under PMJAY, including 17 public and eight private facilities. For a state grappling with pervasive poverty and limited healthcare infrastructure, PMJAY has been a critical safety net, particularly for procedures like dialysis, which can cost around Rs 4,000 per session in private facilities—far beyond the means of daily wage earners. The scheme’s promise of universal healthcare has alleviated the financial burden on families already stretched thin by economic hardship. However, the state’s failure to reimburse private hospitals has pushed them to a breaking point, forcing a choice between financial survival and patient care. This is not a failure of the hospitals but of the government’s inability to uphold its commitments.

The human cost of this crisis is already devastating. In relief camps across Manipur, where families displaced by Manipur violence seek refuge, several kidney patients have died due to the unavailability of dialysis. For those with chronic kidney disease, dialysis is not optional—it is a lifeline. Missing even a single session can be fatal, yet the state’s healthcare system is failing to deliver. Private hospitals, which have been providing free dialysis under PMJAY, are now warning of an impending halt. 

Speaking to a local media at a press meet at the Manipur Press Club on August 8, 2025, Athokpam Manglembi, the wife of a dialysis patient at Shija Hospital has described the looming threat: “From August 16 onwards, private hospitals have informed patients that they will stop providing free dialysis to those undergoing treatment under PMJAY. This will put countless lives at risk.”

Her story resonates with countless others. A diabetic patient from Ukhrul district, who has relied on twice-weekly dialysis in Imphal for over a decade, called the suspension “devastating.” Traveling long distances for treatment is already a burden for rural patients, many of whom live hand-to-mouth. Another woman from Thoubal district, whose father has required dialysis since 2019, emphasized the strain on families like hers. “We cannot afford these costs,” she said, noting that government hospitals, with limited dialysis slots and waiting lists stretching up to a year, are not a viable alternative. “A patient may die if dialysis is not done for a week,” she warned. The desperation was palpable at the August 8 press meet, where dozens of patients and their families gathered to demand urgent government intervention. Their plea was clear: clear the dues, save our lives. Manglembi also appealed directly to the Governor of Manipur and senior health officials, urging them to release the pending funds immediately. The suspension of PMJAY services, she warned, could lead to a catastrophic loss of life.

Manipur is not alone in its struggle. In Haryana, 650 private hospitals suspended PMJAY services as of midnight on August 6, 2025, over unpaid bills amounting to Rs 490 crore and inadequate budget allocations. This decision affects 1.8 crore enrolled beneficiaries, including low-income families and senior citizens, who now face a healthcare void. On August 2, 650-700 private hospitals in Haryana announced their exit from the scheme, effective August 7, citing the same issue of unpaid dues. Jammu and Kashmir and Rajasthan are also grappling with similar challenges, as private hospitals buckle under the weight of delayed reimbursements. PMJAY, designed to provide universal health coverage to nearly 55 crore economically disadvantaged individuals—India’s bottom 40 percent—is unraveling across multiple states, leaving millions at risk.

The parallels between Manipur and these states highlights a systemic failure in PMJAY’s implementation. Private hospitals, which play a critical role in bridging gaps in public healthcare infrastructure, cannot operate indefinitely without reimbursement. In Haryana, the financial strain has led to a complete withdrawal from the scheme, disrupting access for millions. In Jammu and Kashmir and Rajasthan, similar grievances are mounting, with hospitals warning of service suspensions. The ripple effects are profound: families who relied on PMJAY for critical care are now forced to choose between crippling debt and forgoing treatment altogether.

For more than 2 years, the Manipur conflict has disrupted markets, halted businesses, and displaced thousands, many of whom now reside in relief camps with limited access to basic services. Inflation has soared, and livelihoods have been upended, leaving families unable to cope with additional burdens like healthcare costs. In this context, PMJAY is more than a healthcare scheme—it is a lifeline for Manipur’s poorest. By covering hospitalization costs for critical treatments, it alleviates the financial strain on families already stretched thin. For dialysis patients, who require regular and expensive care, PMJAY has been a godsend. The scheme’s benefits extend beyond individual households, supporting the state’s overburdened public health system by leveraging private hospitals’ capacity.

Haryana, too, faces economic pressures that make PMJAY’s role critical. While less conflict-ridden than Manipur, the state’s large population of low-income families and seniors depends heavily on the scheme for access to healthcare. The suspension of services by 650 hospitals threatens to exacerbate existing inequalities, leaving the most vulnerable without recourse. In Jammu and Kashmir and Rajasthan, similar economic challenges—combined with bureaucratic inefficiencies—have strained the PMJAY framework, undermining its promise of universal coverage.

The government’s delay in clearing PMJAY dues is not a mere administrative oversight—it is a systemic failure with deadly consequences. Private hospitals, despite their commitment to public health, cannot operate indefinitely without reimbursement. The financial strain has pushed them to a breaking point, forcing them to prioritize survival over service. This is not a choice they make lightly; it is a response to the government’s negligence. In Manipur, the state’s financial instability cannot be an excuse for inaction. The people, already battered by poverty and conflict, deserve better. The government has a moral and legal obligation to ensure that PMJAY functions as intended. By failing to pay dues, it is effectively denying this right to citizens who have no other recourse.

This shutdown of healthcare schemes demands immediate and decisive action. State governments, in coordination with the Ministry of Health and Family Welfare, must prioritize the release of pending PMJAY funds to private hospitals. In Manipur, where lives hang in the balance, delays are not just bureaucratic—they are lethal. The same urgency applies to Haryana, Jammu and Kashmir, and Rajasthan, where millions face the loss of critical healthcare access. Clearing dues is not a favor but a responsibility—a commitment to the promise of universal healthcare.

Beyond immediate action, systemic reforms are essential. The State Health Agencies responsible for overseeing PMJAY must streamline reimbursement processes, conduct regular audits, and ensure transparent communication with private hospitals. These steps can rebuild trust and prevent future disruptions. The central government must also play a stronger role in holding states accountable, ensuring that budgetary allocations for PMJAY are sufficient and disbursed promptly.

For the people of Manipur, Haryana, Jammu and Kashmir, and Rajasthan, PMJAY is non-negotiable. It is a lifeline that cannot be allowed to falter. The government’s failure has already cost lives, and further delays will deepen the suffering. Patients like those in Ukhrul, Thoubal, and Imphal—or the 1.8 crore beneficiaries in Haryana—cannot wait for bureaucratic wheels to turn. Their lives depend on immediate action.

Sensing the gravity of the situation, Maheshwar Thounaojam, National Secretary of RPI Athawale, has submitted a memorandum to Union Minister of Social Justice & Empowerment, Ramdas Athawale, urging immediate action to address the issue and restore services. The letter appeals Union Minister Ramdas Athawale to urge the Ministry of Health & Family Welfare to immediately disburse the pending PMJAY funds to private hospitals in Manipur, ensuring uninterrupted healthcare services.

Moreover, the Moirang MLA Thongam Shanti Singh is in talks with Raj Medicity, a leading private hospital in the state, to launch a new health scheme exclusively for Below Poverty Line families in his constituency. This initiative aims to bridge the gaps in PMJAY and CMHT healthcare coverage. Private hospitals like Shija Hospital in Langol and Raj Medicity in Imphal already offer health check-up schemes starting at Rs 2700, covering chronic conditions such as diabetes, hypertension, and heart issues.

India’s poorest cannot bear the cost of government inaction. PMJAY was a promise to protect the vulnerable, to ensure that no one is denied healthcare due to poverty. Breaking that promise is a betrayal of trust, a betrayal of lives. The scheme’s suspension, set to begin on August 16, 2025, unless dues are cleared, is a ticking clock. Every day of delay pushes more families toward financial ruin and untreated illness. The government must act now—clear the dues, restore the scheme, and reaffirm its commitment to the health and dignity of the people!