The manifesto's health guarantee is unusually large: ₹25 lakh of insurance cover for every family in Tamil Nadu, explicitly not restricted to below-poverty-line households, alongside five new multispeciality government hospitals, a ₹500 crore annual mental health budget, 24/7 tele-consulting, and permanent status for temporary nurses.

Twelve weeks in, none of this has a published design. That is not by itself a criticism — a universal insurance scheme of this size is a multi-year build, and no government could have launched it by July. It is recorded here because the promise tracker needs a starting point, and because the 5 August budget is the first test of whether the commitment is real.

This portfolio is therefore left ungraded. The inherited system — including the existing state insurance scheme, PHC and government hospital staffing, and drug procurement — continues substantially as it was, and there is no verifiable July-2026 record on which a fair verdict could rest.