Biometric health identity in India: controversial interoperability and data doubles

In less than a decade, access to most of India’s welfare schemes has been digitalised. Biometric IDs such as AADHAAR, PM-JAY and ABHA are now required to access healthcare and welfare. What is the genealogy of these identification systems? How are citizens navigating between multiple health IDs? What kind of data are these IDs encapsulating? How are these databases communicating? What is the role of state, parastatal and private actors in building/maintaining these infrastructures? With a multisited ethnography of digital health infrastructure in India, our paper builds on a genealogy of biometric identification in public health. It relies on archival and ethnographic materials collected between 2017 and 2024 in Bihar, Jharkhand, Chhattisgarh, Tamil Nadu, Puducherry and Kerala. Analysing the politics of unique identification in healthcare and welfare, we detail the differences and common grounds between digital systems that are confusing citizens and displacing their datafied identities. Our analysis suggests that public health insurance for the poorest often turns out to be a testing ground for digital innovation. The most vulnerable strata of the population are bound to experience the complexity, duplicity, and breakdowns in the digital systems to exert their right to healthcare and welfare.