IN January 2019, West Bengal Chief Minister Mamata Banerjee declared that her state would stop implementing the prime minister’s flagship health insurance scheme – PMJAY/Ayushman Bharat – which provides up to Rs 5 lakh health cover per family per year.
‘Today we are withdrawing from the Ayushman Bharat scheme. Now, the Centre will have to bear the entire cost of the scheme as we will no longer pay our share of the money. Why should we pay if it [Centre] takes all the credit? The Centre is sending letters to people from post offices saying that it has done health insurance for them. How can they take credit when the state governments bear 40 per cent of the cost for this scheme?’1
Similarly in Madhya Pradesh, the new Congress state government led by Kamal Nath decided not to facilitate implementation of the PM-KISAN cash transfer programme, introduced in February’s Union budget as a bid to reverse farmer dissatisfaction ahead of the 2019 Lok Sabha elections. Former BJP Chief Minister Shivraj Singh Chauhan said that the new state government was deliberately not cooperating with the central government’s PM-KISAN scheme by refusing to share its list of farmers with the central government. He said ‘The MP government is not sending the list of farmers as it feels Modi will benefit if the money goes into the accounts of the farmers.’2
Attempting to put clear water between the BJP’s national scheme and the state government’s policy, Kamal Nath announced instead that his state government would be rapidly implementing its own loan waiver scheme before the Lok Sabha elections.
Decisions by state governments to either block or hinder the implementation of national policies – even where they are fully funded by the Centre – illustrate the ways in which political competition between the central and state governments can undermine the effective reach of centrally designed social policies.
Sara Niedzwiecki’s new book, Uneven Social Policies, explores precisely these dynamics in the context of social policy implementation in federal settings. While Niedzwiecki studies Latin American federations, there are many insights from her work that would be useful for understanding the dynamics in India.3
Niedzwiecki argues that there are two main types of social policy. First, there are a set of policies that clearly ‘belong’ to the national government and in which the attribution of responsibility for the policy is very obvious to voters. As examples, she uses conditional cash transfer (CCT) schemes such as Brazil’s Bolsa Família (family allowance)or Argentina’s Asignación Universal por Hijo (universal child allowance). With these programmes there is a direct transfer of cash from the central government to individual beneficiaries on a non-discretionary basis and without the involvement of intermediaries at the state level. It is clear to individual beneficiaries that CCTs are central government policies, and there is evidence that these kinds of policies have helped national presidents get re-elected in countries ranging from Mexico, Brazil to Uruguay.
With such policies, Niedzwiecki argues, there are strong incentives for opposition ruled subnational governments to hinder or refuse to implement them. They have various means of doing so, including refusing to share lists of beneficiaries with the national government, or simply failing to instruct their staff to work on national policies. They can also introduce their own programmes which compete with national programmes.
Second, there are a set of policies in which attribution of responsibility is less clear. This includes the case of social services such as health care, where funding is transferred from higher levels of governments to clinics or health care providers at the subnational level. It is less easy for voters to attribute responsibility for such services to a particular layer of government.
For such services, Niedzwiecki suggests, the quality of implementation is less affected by vertical political alignment between the national and subnational governments. There is still considerable unevenness in how these policies are implemented across space, but the variation is caused by institutional capacity and the nature of subnational policy legacies, rather than by a deliberate attempt by opposition ruled subnational governments to undermine the performance of national policies.
Niedzwiecki tests her theory about the impact of vertical political (non) alignment on the implementation of different types of social policies with a mixture of statistical and qualitative analysis, focusing on the two most decentralized countries in Latin America – Argentina and Brazil. She finds that while the implementation of CCTs is negatively affected by having an opposition governor, the presence of an opposition governor is irrelevant for health policies because attribution of responsibility is unclear.
The author’s qualitative research also provides examples of ways in which federal governments can improve policy implementation by sharing credit with subnational levels of government. For instance, in Brazil, some years after introducing Bolsa Família,the federal government invited states to complement the CCTwith their own programmes and allowed them to put their state logo alongside that of the federal government on the ATM cards used by recipients to withdraw funds (p. 138).
Unfortunately, Niedzwiecki herself does not consider whether her theory of the politics of social policy extends to India, although she presents evidence to suggest that it holds in the case of the United States. There are, however, plenty of signs to suggest that it would be fruitful to extend her analysis to India in order to explore how national level credit-claiming and attribution affect the implementation of different types of social policy. If India is to move closer towards territorial universalism in welfare provision, it is crucial to understand these issues better.
Louise Tillin
King’s College London
Author of Indian Federalism, 2019
Footnotes:
1. ‘Mamata Banerjee pulls out of PMJAY, says Centre taking credit’, Indian Express, 11 January 2019 https://indianexpress. com/article/india/mamata-banerjee-pulls-out-of-pmjay-ayushman-bharat-scheme-says-centre-taking-credit-5532864/ West Bengal eventually agreed to implement the national programme, but under a joint banner with its own scheme – Ayushman Bharat – Swasthya Sathi with the cost shared between the central government and state government on a 60:40 basis.
2. ‘Congress-ruled Madhya Pradesh focuses on own loan waiver scheme, delays PM Kisan Nidhi’, Economic Times, 6 March 2019.
3. For a preliminary discussion of some of the contrasts between Latin America and India in this area, see Louise Tillin and Anthony Pereira, ‘Federalism, Multi-Level Elections and Social Policy in Brazil and India’, Commonwealth and Comparative Politics 55(3), 2017; and articles in a special issue of Regional and Federal Studies 29(2), 2019 entitled ‘Negotiating Universalism in India and Latin America: Fiscal Decentralisation, Subnational Politics and Social Outcomes’, edited by Andres Mejia Acosta and Louise Tillin.
