Out-of-pocket expenditure (OOPE) largely finances healthcare expenditures in India, especially of the marginal, vulnerable sections of the society and those living in rural areas. This has increasingly led to impoverishment and poor health-seeking behaviour. In the year 2008, the Government of India launched its flagship health insurance scheme called Rashtriya Swasthiya Bima Yojana (RSBY), which aimed to provide insurance cover to around 65 million families from below poverty line strata. The present paper uses secondary data from published literature in reputed journals to analyze the performance of the scheme draw comparisons with a recently launched more robust scheme for health insurance, namely, Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY), which aims to bring health insurance cover to 10.74 million poor and vulnerable families. The social marketing of RSBY was studied to understand resultant behavioural change among the poor population in terms of decrease in OOPE and non-health seeking behaviour, improvement of women's health and overall health insurance utilization. The study shows that RSBY is not generating the required results. RSBY effect on reduction in catastrophic OOPE was not found for both inpatient and outpatient spending. Over time no major behaviour change in terms of utilization and adoption of health-seeking behaviour was found. Social Marketing can help policymakers to design planned interventions and schemes for the long term success of health insurance in India.
