ADB Approves $108m Loan to Help Mizoram Achieve Universal Health Coverage

Recognizing Mizoram’s exposure to climate-related health risks, the program also integrates environmental adaptation and disaster preparedness measures into health service delivery.

The Asian Development Bank (ADB) has approved a $108 million results-based loan to support the Government of Mizoram, India, in strengthening its public health care system and advancing toward universal health coverage (UHC), marking a major milestone in health sector reform for the northeastern state.

The financing will support the Supporting Public Health Care System Strengthening to Achieve Universal Health Care for Mizoram Program, which aims to ensure equitable access to affordable, high-quality health services for the state’s 1.38 million residents. The program places particular emphasis on improving health outcomes for women, older persons, persons with disabilities, and other vulnerable groups, who often face barriers to accessing timely and quality care.

At the core of the reform is the rollout of the Mizoram Universal Health Care Scheme (MUHCS), a unified health insurance system designed to bring all residents under a single coverage framework. According to ADB Country Director for India Mio Oka, the program will integrate and strengthen existing national and state-level schemes, including the Pradhan Mantri Jan Arogya Yojana (PM-JAY) and the Mizoram State Health Care Scheme, into a seamless, cashless, and paperless platform.

Under MUHCS, every household in Mizoram will be eligible for health insurance coverage of up to INR 500,000 per family per year. The state government will fully subsidize premiums for poor and vulnerable households, ensuring free access to essential health services. Other households will contribute affordable premiums, while government employees will make contributions through a fixed share of their salaries. This blended financing model is designed to ensure both inclusivity and long-term financial sustainability.

With ADB’s support, Mizoram becomes the first state in India to undertake this comprehensive, results-based reform toward universal health care, positioning it as a potential model for other states seeking to strengthen public health systems while expanding coverage.

The program directly addresses Mizoram’s growing health challenges, particularly the high prevalence of noncommunicable diseases (NCDs) and cancer, which together account for more than 50% of the state’s disease burden. Investments will support early detection, improved diagnostics, and better treatment pathways, helping to reduce preventable deaths and long-term health costs.

Recognizing Mizoram’s exposure to climate-related health risks, the program also integrates environmental adaptation and disaster preparedness measures into health service delivery. Awareness campaigns, strengthened emergency response systems, and climate-sensitive health planning will help communities cope with health impacts linked to extreme weather events such as floods and landslides.

A key feature of the program is the strengthening of the continuum of care. Primary health care services will be better linked with secondary and tertiary facilities through MUHCS, ensuring that patients receive timely referrals, follow-up treatment, and comprehensive care across all levels of the health system.

In parallel, the program will build institutional capacity within the Department of Health and Family Welfare, primary health care units, and the Mizoram State Health Care Society, which is responsible for implementing MUHCS. Improvements in governance, health financing, data systems, and service quality are expected to enhance efficiency, accountability, and patient outcomes.

Overall, the ADB-supported initiative is expected to significantly reduce out-of-pocket health expenditures, improve access to quality care, strengthen system resilience, and accelerate Mizoram’s progress toward universal, inclusive, and climate-resilient health coverage.