Kathmandu: In a decisive move to sustain its national health insurance programme, the Ministry of Health of Nepal has allocated NPR 750 million (approximately USD 5.25 million) to ensure uninterrupted operations across the country. The funds will be disbursed directly through the Nepal Health Insurance Board, the agency responsible for administering the programme.
Launched in 2016, the scheme primarily targets low-income households, providing them with critical health coverage. However, this year the programme faced severe operational challenges as more than three dozen private and community hospitals suspended insurance-based services. This disruption left hundreds of thousands of citizens without access to essential care, intensifying financial and health pressures on vulnerable populations.
According to media reports, the NPR 750 million allocation has been reallocated from other health service budgets within the current fiscal year. Dr. Krishna Prasad Paudel, Executive Director of the Nepal Health Insurance Board, stated, “We have been able to secure partial funding from the Ministry of Health. Additionally, we are hopeful to obtain another NPR 1 billion to address ongoing issues.” The board has disclosed that private hospitals are collectively owed approximately NPR 11 billion, a factor that contributed to the suspension of services.
Current data indicates that around 92% of registered citizens are actively utilising the insurance benefits, placing considerable strain on the limited financial resources of the programme. Experts highlight the urgent need to review premium rates and introduce an income-based premium system to ensure sustainability.
Professional analysts have frequently criticised the programme for being run in a manner resembling a social welfare initiative rather than a financially sustainable insurance model. The board’s projections suggest that outstanding payments to private hospitals could reach NPR 26 billion by the end of 2026 if corrective measures are not implemented.
Key Data of Nepal Health Insurance Programme
| Aspect | Details |
|---|---|
| Year Established | 2016 |
| Recent Fund Allocation | NPR 750 million (~USD 5.25 million) |
| Expected Additional Funding | NPR 1 billion |
| Outstanding Hospital Payments | NPR 11 billion |
| Projected Future Liabilities | NPR 26 billion (by 2026) |
| Programme Utilisation | ~92% of registered citizens |
| Primary Challenges | Funding shortfall, shortage of medicines and equipment, human resource constraints |
Through this funding, the Nepalese government aims to stabilise the health insurance programme and safeguard access for low-income populations. Nevertheless, long-term sustainability will require a comprehensive reassessment of premium structures and a commitment to financial stability to prevent future service disruptions.