The Chief Minister's Health Insurance Scheme (CMHIS) now covers nearly 96 per cent of households in Nagaland, with the state government bearing a growing financial burden to sustain the programme amid rising insurance premiums, officials said on Friday, June 19.

Speaking at a seminar on CMHIS jointly organised by the High Court Bar Association (HCBA), Gauhati High Court's Kohima Bench, and the Nagaland Health Protection Society (NHPS), NHPS Joint Chief Executive Officer Dr Kikameren Longkumer said the scheme was launched in 2022 to bridge healthcare coverage gaps under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PM-JAY).

According to Longkumer, while PM-JAY covers around 2.59 lakh families in Nagaland, CMHIS extends health insurance benefits to government employees, pensioners and households that fall outside existing government health schemes.

Under CMHIS, government employees and pensioners are entitled to health insurance coverage of up to Rs 20 lakh per family annually. Another component of the scheme provides coverage to uninsured households classified under the "missing middle" category.

Longkumer said the scheme currently covers around 97,185 households of government employees and pensioners, along with another 20,000 households under the missing middle category, bringing overall coverage to nearly 96 per cent of the state's estimated 3.97 lakh households.

He noted that government employees and pensioners contribute 50 per cent of one month's Dearness Allowance annually towards the scheme, generating around Rs 60 crore. However, insurance premiums have risen sharply from approximately Rs 1,500 per family when the scheme was introduced to Rs 9,670 at present.

As a result, the annual premium payable has increased to nearly Rs 94 crore, requiring the state government to contribute an additional Rs 30-34 crore to sustain the scheme, Longkumer said.

Apart from this, the state also contributes around Rs 40 crore towards PM-JAY and another Rs 10 crore for CMHIS coverage of the missing middle category.

He said the scheme currently covers hospitalisation expenses only because of financial constraints, though outpatient department (OPD) services may be included in the future.

Beneficiaries can avail cashless treatment at empanelled hospitals both within and outside Nagaland. Around 60 to 70 hospitals outside the state have been empanelled under the scheme, with only NABH-accredited institutions included to ensure quality healthcare services.

Addressing the seminar, Justice Nelson Sailo of the Gauhati High Court's Kohima Bench described healthcare as a constitutional right under Article 21 and said CMHIS had significantly expanded access to healthcare for people across the state.

He said a strong healthcare system protects families from financial hardship while contributing to improved public health and quality of life.