The 80th NSO health survey shows expanded insurance coverage due to PMJAY, tripling access. However, hospitalisation rates haven't recovered to 2014 levels, with hidden costs and low private hospital reimbursement still limiting actual access. State-funded schemes subsidize private care without price regulation, while also providing a hospitalisation safety net. Mean out-of-pocket expenses doubled, but median dropped for primary/secondary care, making it more affordable. Yet, catastrophic costs persist for some due to underfunded public chronic care. Future reforms must strengthen public sector tertiary care to compete with private providers.