Currently, only approximately 5% of the GDP is spent on health. Private spending accounts for more than 80 percent of all health spending, and a vast majority of this is out-of-pocket. Cost remains a significant barrier to use of health care, particularly for the poor, who are not able to afford care of the quality and frequency needed. Health insurance is a health financing mechanisms that can address some of the issues related to access and equity to quality health services. Less than 10 % of Indians have access to any health insurance.

Heath Systems 20/20 (HS 20/20) provides technical expertise to national and state governments in the design and implementation of health insurance programs.

In collaboration with national and state governments, HS 20/20 is supporting the design and implementation of health insurance toward reducing financial barriers to health care and improving the quality of public and private health care in USAID priority states, i.e, Jharkhand, Uttar Pradesh, and Uttarakhand. Key activities will include:

• Conducting a health insurance workshop with key stakeholders in the three priority states for the purpose of developing a detailed roadmap for piloting health insurance in these states;
• Supporting USAID priority states in the design of a health insurance pilot project, tapping into the expertise of local institutions for implementation of key studies that inform the development of a quality health insurance scheme;
• Leveraging Ministry of Labor and Ministry of Health and Family Welfare (MOHFW) resources to launch a sustainable, affordable, quality health insurance scheme;
• Working with public and private health care providers to enhance the quality of health care provided; and
• Implementation and evaluation of health insurance pilot schemes.