Article’s

Healthcare financing in Gujarat represents a sophisticated blend of public-private partnerships (PPP), state-funded insurance, and a rapidly expanding private medical sector. While the state serves as an economic powerhouse in India, it faces the dual challenge of addressing significant “Out-of-Pocket” (OOP) expenditure and ensuring equitable access across a diverse rural-urban divide. This paper examines the fiscal evolution of Gujarat’s health sector, with a specific focus on the transition from the Mukhyamantri Amrutam (MA) Yojana to the integrated Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). It analyzes the landmark 2025 policy shift that increased coverage to ₹10 lakhs and provided universal access to senior citizens (U70). Through a mixed-methods approach, the study identifies structural opportunities in digital health and fiscal hurdles in reaching the “missing middle” population. By evaluating the socio-economic dividends of a healthier workforce, the paper underscores the direct correlation between health security and the state’s continued industrial GDP growth. Ultimately, this paper proposes a ‘Gujarat-specific’ co-contribution model as a viable financial roadmap for covering the informal labour sector, ensuring that the march toward Universal Health Coverage (UHC) is both inclusive and fiscally resilient.”