Govt Ends Funding for Provincial Health Schemes

The federal government has decided not to provide any funding for provincial health coverage, including insurance schemes, in line with the 18th Constitutional Amendment, and has asked provinces to explore full-fledged contributory health insurance models.

The decision was taken after the government approved the continuation of the Sehat Sahulat Programme for selected federal territories only, with no extension planned for provincial populations, reported Dawn.

According to the report, the programme, with a revised cost of Rs. 40.2 billion, has been extended until June 30, 2027, but its scope has been restricted to the Islamabad Capital Territory, Azad Jammu and Kashmir, and Gilgit Baltistan.

The decision followed a high-level meeting chaired by the prime minister on January 2, after which the Prime Minister’s Office issued a directive on January 9 confirming that the programme would continue beyond June 30, 2025 only for the three federally administered regions.

Against this backdrop, internal proposals to include Sindh’s Tharparkar district under the Sehat Sahulat Programme were not supported during meetings of the Central Development Working Party and the Executive Committee of the National Economic Council.

Documents show it was argued that allowing inclusion of even a single district from a province would open the door to similar demands from other provinces, despite health being a devolved subject after the 18th Amendment.

Earlier, on August 7, 2025, Ecnec had approved the formation of a special committee to review the programme since its launch in 2015. The committee concluded that the Sehat Sahulat Programme had completed its lifecycle on June 30, 2025 after multiple extensions and should be shifted to the current budget rather than continuing as a development project.

The committee directed the Ministry of National Health Services to submit a project completion report and propose a limited structure to sustain indoor healthcare services for vulnerable populations, in line with the programme’s original intent.

It further recommended that provinces, along with AJK and GB, should continue or develop their own social health protection schemes through their respective budgets.

The committee strongly opposed extending the federal programme to provincial districts, citing the devolved nature of health and the already overstretched Public Sector Development Programme, which it said could not absorb additional liabilities.

However, it suggested that after shifting the completed project to the recurrent budget, the health ministry, in coordination with provinces, could design a pilot scheme based on claim co payments, similar to Punjab’s model, and work towards a full scale social health insurance system on a contributory basis.

The Sehat Sahulat Programme was originally approved on February 7, 2018 under the Prime Minister’s National Health Programme Phase Two at a cost of Rs. 34 billion. It aimed to provide health coverage to families living below the poverty line using data from the Benazir Income Support Programme.

Over time, the programme expanded through multiple revisions. In August 2019, the federal government stopped provincial contributions for priority care treatment in most regions, citing the spirit of the 18th Amendment. The programme formally ended on June 30, 2025.