ESIC continues to abandon adult dependents with disabilities
The benefits available under ESIC include medical treatment, maternity, pension for dependents and disablement etc.
As the labour laws take a new look in India, the Employees' State Insurance (ESI) Act, 1948 continues to abandon the lakhs of dependent adults with disabilities.
The benefits available under ESIC include medical treatment, maternity, pension for dependents and disablement, etc. Among the benefits, it covers the treatment of the workers and their dependents including parents, siblings and children. The children remain insured until they are 25 and siblings until they are 18[1]. There is no exemption for the sons or daughters or siblings with disabilities who may continue to remain dependents, even after that age.
The ESI scheme covers a significant population that falls in the economically weaker section (EWS). It applies to all those who monthly earn upto Rs 21,000 (upto Rs 25,000 for workers with disabilities). As on March 31, 2020[2], there were about thirty-one million employees covered under ESIC.
Census 2011: 2.21% of the total population with disabilities
During the Census 2011, 26.8 million were found to be persons with disabilities (PwDs), i.e. 2.21% of the total population. Somehow, the number reduced to 21.9 million in the response of the Minister of State for Social Justice and Empowerment to the Parliament in 2013[3]. While there is no data on the economically disadvantaged PwDs, the beneficiaries drawing disability pension in India gives a relative number since the pension is only given to those from EWS. An information sought by this writer under the Right to Information Act, 2005 suggests that there are 772,220 disability pensioners (including minors). Notably, not all economically vulnerable PwDs would have access to the pension. Furthermore, the disability pension isn't a very sustainable amount, which ranges from Rs 500 to Rs 3000 per month depending on the state and disability. As per a study by Equiv.in, a recruitment platform, only 3.4 million of about 13.4 million people with disabilities of the employable age had jobs in 2019[4]. The employability number would have decreased and the need for insured treatment would have only increased during the pandemic.
Act provides social security and health insurance
The Act was one of the first major legislations of independent India that provided social security and health insurance to the workers and their immediate family members. The coverage of Employees State Insurance Corporation (ESIC) is extended to all establishments employing 10 or more employees across the country. Under the scheme, the employers and employees contribute 3.25% and 0.75% of the employee's monthly income, respectively. The reach and provisions of ESIC is better than the Prime Minister Jan Arogya Yojana (PMJAY), another central government health insurance scheme for EWS. The former is extended to 35 states and union territories in India while the latter is limited to 32[5]. PMJAY is not applicable for out-patient care and diagnosis[6], while ESIC covers these along with wage loss due to sickness. Also, ESIC coverage does not exclude anyone due to the nature of work while PM-JAY does. For instance, a journalist earning less than Rs 21,000 in Mumbai is eligible for ESIC but not for PM-JAY[7]. Yet, the journalist's adult sibling with disability won't be covered in either schemes.
On February 24, the ESIC scheme turned 69
On February 24, the ESIC scheme turned 69 from the time it was inaugurated by the then Prime Minister Late Pt Jawaharlal Nehru. Last year, India decided to compress 29 existing labour laws into four codes, which shall be effective from April 1. Under the new labour codes, the ESIC Act has been made part of the Social Security Code, with no modification to accommodate the dependents due to disabilities. Talking about the welfare of the labourers in India and reintroducing the four labour codes, Finance Minister Nirmala Sitharaman in her Budget Speech extended the coverage of ESIC to all kinds of workers[8]. It meant the extension of the ESIC coverage to the informal sector too. Section 45 of the Social Security Code says that the Central government by notification may frame a scheme to provide the benefits of the scheme to the unorganized workers, gig workers and platform workers and their family members. However, with just one month left, neither has the government framed any scheme nor initiated their registration.
Economic Survey 2020-21
As per the Economic Survey 2020-21, health insurance is desirable due to the uncertainty and variability, and that private insurances are non-preferred due to high premiums and restraints in coverage. In reference to the United States, the annually released report also suggests that health insurance coverage provided by the government is vital in providing for better health care and health outcomes; and that the likelihood of financial insecurity, medical debt or bankruptcy is reduced if the families have access to the insurance programs. Yet, the Central government in India is taking the ESIC ahead with its limitation on people with disabilities or the 'Divyangs', as the current Prime Minister Narendra Modi prefers to address them.