China’s streamlined medical insurance now covers 95% of citizens, enabling instant newborn enrollment and broader benefits, including maternity and long-term care. Digital upgrades and oversight boost access, equity, and efficiency across the country’s healthcare system.
China has rapidly enhanced its healthcare security framework during the 14th Five-year Plan (2021–2025), making it easier and more accessible for citizens to enroll in and benefit from basic medical insurance programs. For instance, parents like Ms. Liu in Jinan can now enroll newborns for publicly funded insurance straight from their hospital beds, simply by using the birth certificate. This reflects sweeping reforms that have eased enrollment restrictions and utilized digital platforms to encourage participation and ensure swift payments. The country presently maintains an impressive 95 percent enrollment rate, with about 20 billion insurance reimbursements processed in the last four years.
Funding for basic medical insurance differs for various population groups: rural residents and non-working urbanites benefit from individual payments and substantial government subsidies, while urban employees’ insurance is supported by both employees and their employers. The system continues to expand, adding categories such as maternity insurance and long-term care insurance, and adopting policies that streamline access even for flexible workers—allowing them to enroll based on residence or workplace rather than household registration. Continuous insurance coverage now attracts greater benefits, particularly for critical illness insurance, which has notably eased financial hardship for 673 million rural low-income earners, saving them over 650 billion yuan.
Maternity insurance coverage has reached 253 million women, with the fund disbursing more than 438 billion yuan in allowances. Assisted reproduction treatments and long-term care insurance pilots now span dozens of provinces and cities, extending benefits to nearly 190 million participants. China’s basic medical insurance fund has adopted policies allowing cross-provincial usage and enabling account holders to pay for close relatives’ medical expenses.
The list of insured drugs now includes over 3,000 medicines, and 1.1 million designated hospitals have joined the program nationwide. Digital innovations—such as facial recognition for bill payment and online enrollment—have streamlined service delivery, eliminated many bureaucratic hurdles, and improved fraud detection and fund supervision. The National Healthcare Security Administration (NHSA) reports the recovery of over 100 billion yuan through strengthened oversight, with surprise inspections now covering all relevant regions and institutions. Looking forward, the NHSA is dedicated to expanding universal long-term care insurance, demonstrating China’s commitment to both equity and efficiency in public healthcare and laying the foundation for further reforms under the forthcoming new development plan.
