A recent audit report by the Comptroller and Auditor General (CAG) of India has revealed that ₹6,646 crore collected as Health Cess during the 2024-25 fiscal year was not transferred to the Pradhan Mantri Swasthya Suraksha Nidhi (PMSSN), prompting sharp criticism from the Jan Swasthya Abhiyan India, which has demanded accountability from the Union government.
According to the CAG’s audit report on the Finance Accounts of the Union Government for 2024-25, the Ministry of Finance collected ₹21,085 crore as Health Cess during the fiscal year but transferred only ₹14,439 crore to PMSSN, resulting in a short transfer of ₹6,646 crore. The audit report noted that despite repeated observations over the years, the Ministry of Finance has continued the practice of not transferring the full amount of cess receipts to dedicated reserve funds under the Public Accounts of India.
The CAG stated that when the matter was raised with the Ministry of Health and Family Welfare, the ministry replied in January 2026 that the Ministry of Finance was the nodal authority responsible for collecting the cess and allocating it to reserve funds. The audit report added that a specific explanation regarding the short transfer was still awaited.
In its statement, Jan Swasthya Abhiyan India alleged that the Ministry of Finance had repeatedly retained substantial amounts of Health Cess within the Consolidated Fund of India instead of transferring them to the designated reserve fund, which it said undermined transparency and accountability in public finance management. The organisation argued that earmarked cess collections meant for strengthening public healthcare should be ring-fenced and fully traceable.
Data compiled from CAG audit reports between 2018-19 and 2024-25 showed that the Centre collected ₹96,627 crore as Health Cess during the seven-year period but transferred only ₹46,554 crore to the Public Accounts of India, resulting in a cumulative short transfer of ₹50,072 crore, or nearly 52 per cent of the total collections.
Jan Swasthya Abhiyan India demanded that Union Finance Minister Nirmala Sitharaman explain why a separate accounting head for Health Cess was not created until March 2021 and why repeated CAG observations had not resulted in compliance with constitutional accounting provisions requiring cess collections to be transferred to dedicated reserve funds.
Representatives of the organisation, including Gourang Mohapatra and Rahi Riyaz, said the withheld ₹50,072 crore could have significantly strengthened India’s public health infrastructure by upgrading district hospitals, establishing government medical colleges, improving primary and community health centres, and recruiting healthcare personnel in underserved regions. They also said the funds could have been used to expand emergency and critical care facilities, establish oxygen plants and intensive care units, and improve disease surveillance systems.
Another group of representatives, including Sanjeev Sinha and Amulya Nidhi, alleged that despite the availability of earmarked resources, public health infrastructure and medical education continued to face financial constraints. They claimed that repeated non-expenditure and non-transfer of health funds raised concerns about the weakening of public healthcare services and increasing privatisation in the sector.
The organisation has called for corrective measures to ensure full transfer and effective utilisation of Health Cess funds for strengthening India’s public healthcare system.
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