This chapter explores the evolution and implementation of Government-Funded Health Insurance Schemes (GFHIS) in India, with a specific focus on Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), the country’s largest health insurance scheme. It provides a historical overview of GFHIS, beginning with the launch of schemes such as the Central Government Health Scheme (CGHS) and Employees’ State Insurance Corporation (ESIS) in the late 1940s and early 1950s, and progressing to the introduction of various national and state-level insurance programs designed for different population groups. This chapter highlights the significant shift from supply-side to demand-side financing in India’s healthcare system, marked by the introduction of various state initiatives and national schemes like Rashtriya Swasthya Bima Yojana (RSBY) and ultimately AB PM-JAY. This transition aims to enhance healthcare accessibility and promote a patient-centered approach where funds follow the patient, thereby incentivizing service provision. This chapter describes various aspirational aspects for the implementation of AB PM-JAY and explores the significant reforms in the scheme’s design and implementation to achieve universal health coverage.