The XV Finance Commission health grants are a major step towards decentralizing healthcare by empowering local governments to manage primary health services. Over the five-year period from 2021 to 2026, the commission has allocated a total of 70,051 crore rupees to be distributed among various states and union territories. Out of this, 43,928 crore is dedicated to Rural Local Bodies, while 26,123 crore is earmarked for Urban Local Bodies. The core vision is to ensure that every citizen has access to diagnostic services and basic treatment within a short distance of their home. To achieve this, the grant supports the establishment of block-level public health units that serve as surveillance and diagnostic hubs. It also focuses on upgrading existing sub-centres into functional Health and Wellness Centres that provide a wider range of services, including maternal and child health, communicable disease management, and screening for non-communicable diseases like diabetes and hypertension. State governments must ensure that these funds are not used to replace existing health budgets but rather to supplement them. A critical condition for the release of these grants is the formation of State and District Level Committees that oversee the planning and execution of health projects. The grants are released in two installments each year, and the subsequent releases are contingent upon the submission of utilization certificates and proof of work progress. In rural areas, the funds are specifically utilized for diagnostic infrastructure at sub-centres and primary health centres, as well as the construction of new buildings for facilities currently operating in rented or dilapidated structures. For urban areas, the focus remains on closing the gap in primary care for the urban poor through the creation of urban health units and polyclinics. This structured financial support aims to increase the overall public health spending of states to more than 8 percent of their total budget by 2026, creating a more resilient and responsive healthcare system at the grassroots level.