Asian Development Bank releases first tranche of $108 million loan for Mizoram healthcare scheme

The Asian Development Bank (ADB) has released the first tranche of a $108 million loan to support the implementation of Mizoram's Universal Healthcare Scheme (MUHCS), with the state receiving ₹205.49 crore, officials said.

The ADB released $21.6 million to the Union Ministry of Finance on October 29 after Mizoram achieved two Disbursement Linked Indicators (DLIs) under the programme. The Ministry subsequently transferred ₹205.4858 crore to the state account on November 5. Of the amount received, ₹20.54 crore, or 10 per cent, will be treated as a loan, while ₹184.93 crore, or 90 per cent, will come to Mizoram as a grant. The entire amount will be parked in the Healthcare Corpus Fund to strengthen the financial sustainability of MUHCS, according to the Finance Department.

The state government is targeting the achievement of at least three DLIs during the current financial year and plans to draw and utilise around ₹130 crore under the programme. This issue was discussed during a tripartite review meeting held in Chandigarh earlier this month, involving the state Finance Department, the Department of Economic Affairs, and ADB officials.

Mizoram signed the $108 million ADB loan agreement on January 23 this year. The project became effective from April 1 following visits and consultations by the ADB team. The project was originally proposed in 2022 during the Mizo National Front (MNF) government headed by Zoramthanga to strengthen the corpus fund of the state's healthcare scheme. It was subsequently revived by the present Zoram People's Movement (ZPM) government under the title 'Supporting Public Health Care System Strengthening to Achieve Universal Health Care for Mizoram'. The loan was approved by the ADB board on December 5 last year, following negotiations in October that year.

Under the externally aided project, the Centre will provide 90 per cent of the loan amount to Mizoram as a grant, while the state will repay the remaining 10 per cent to the Centre as a soft loan.

The MUHCS was launched in March 2025 and became operational the following month, providing cashless treatment coverage of up to ₹5 lakh to eligible beneficiaries at government hospitals and empanelled private and church-run hospitals in and outside Mizoram. Government employees, including provisional and muster-roll employees, are required to pay a monthly contribution ranging from ₹200 to ₹1,500 depending on their pay scales to avail unlimited health cover. Pensioners and their spouses can avail up to ₹24 lakh cover per financial year on surrendering their fixed medical allowance of ₹1,000 per month that serves as the baseline subscription fee. Beneficiaries or golden card holders under the Centre's AB PM-JAY scheme need not pay enrollment fees under MUHCS.

The government has stated that strengthening the healthcare corpus through the ADB-supported project would help reduce its recurring expenditure on healthcare premiums and claims and ensure the long-term sustainability of the scheme.

"The structuring of this financial arrangement, combining a 90 percent grant with a 10 percent soft loan through central backing, offers a sustainable financial model for state-level public welfare initiatives. Parking these funds into a dedicated corpus ensures long-term operational viability while reducing recurring fiscal burdens on the state exchequer. For public-private health infrastructure models, linking disbursements to specific milestone achievements creates an effective framework for governance and accountability." — Dr. Shishir Gupta, Founder & CEO, StartupLanes