Researchers have the view that functional and representative democratic political institutions have long characterized the role of the Institution in the development of the country and India. This paper brings the political economy issue, and the role of the institution played in obtaining Rashtriya Swasth Bima Yojana (RSBY) health insurance scheme card in India. The objective is to analyse the role of village and household characteristics in obtaining RSBY scheme card holding in rural India. Also, to examine the role of political connection, public good activism and network of the household in enrolment in RSBY scheme. This study uses the Indian Human Development Survey (IHDS), 2011-12 data. The method of analysis is the bi-variate and logistic regression. This study found that the network and variable related to information availability, i.e. household with a membership of caste association and attending of a public meeting are more likely to enroll in RSBY scheme. There is not much difference of RSBY card holding between the household that has a political connection, and household that does not have a political connection. Social group result does have an unexpected result of the ST population have less than national level card holder. The village level characteristics like Pradhan caste and reservation of the seat is positively linked to RSBY card holding. A Village that has implemented Janani Suraksha Yojana (JSY) scheme their household have less percentage of RSBY card holder that village.