Archive · 29 Jul 2026
CAG flags breaches in West Bengal's Swasthya Sathi scheme
The Comptroller and Auditor General (CAG) has found that the Swasthya Sathi health insurance scheme in West Bengal, launched by the TMC government in 2017, may have been misused.
The scheme, which covers all permanent residents with no cap on family size, had 2.43 crore families enrolled as of March 2023.
However, only 2.21 crore families held ration cards as of August 2023, suggesting that some ineligible beneficiaries might have received benefits.
The CAG also found issues with hospital grading and payments, non-recovery of penalties, and excess expenditure on smart cards.
The scheme's grievance redressal mechanism was also found to be lacking.
The CAG report is the first in four years in Bengal, following the BJP's replacement of the TMC in power.
CAG reports potential misuse of Swasthya Sathi scheme with 10% higher enrollment than ration card holders.
Scheme covers all permanent residents with up to Rs 5 lakh annual coverage, fully funded by the state.
Issues identified include improper hospital grading, non-recovery of penalties, and excess expenditure on smart cards.
No mechanism for tracking grievance redressal was found.
CAG reports published for the first time in four years in Bengal under BJP government.
- Who
- Comptroller and Auditor General (CAG), Trinamool Congress (TMC) government headed by Mamata Banerjee
- What
- CAG report highlighting breaches in the Swasthya Sathi health insurance scheme
- When
- Scheme launched in February 2017, CAG report based on data up to March 2023 and August 2023
- Where
- West Bengal, India
- Why
- To audit and highlight discrepancies and potential breaches in the implementation of the Swasthya Sathi scheme
TMC Government
CAG Report
Eligibility of Beneficiaries
TMC Government
The scheme was designed to cover all permanent residents, with the government citing decadal growth and family splitting as reasons for the higher enrollment numbers.
CAG Report
The number of families enrolled under the scheme was 10% higher than those holding ration cards, raising concerns about ineligible beneficiaries.
Hospital Grading and Payments
TMC Government
The government expanded the scheme to cover all permanent residents, ensuring comprehensive health insurance.
CAG Report
The CAG found that none of the 27 empanelled government super speciality hospitals were graded as Grade-A, leading to lower payments, and 31 hospitals were improperly allowed higher grading.
- Scheme Launch
- February 2017
- Total Enrollment (as of March 2023)
- 2.43 crore families
- Ration Card Holders (as of August 2023)
- 2.21 crore families
- Coverage
- All permanent residents except those covered by other government health insurance schemes
- Premium Payment
- Entirely paid by the state government
- Annual Coverage
- Up to Rs 5 lakh per family
- Grievance Redressal
- No mechanism to track redressal of grievances
- Excess Expenditure
- Rs 46.97 crore on enrolment and distribution of smart cards