BEIJING: The National Healthcare Security Administration has pledged to expand medical insurance coverage, strengthen support for medical innovation, streamline services and tighten fund supervision during the 15th Five-Year Plan period (2026-30), aiming to deliver more accessible and equitable healthcare security for China’s 1.33 billion medically insured people.
At a news conference held on Friday by the State Council Information Office, senior officials detailed the administration’s priorities for the 2026-2030 period, building on solid progress made during the previous five years. The country now maintains the world’s largest basic medical insurance network, with coverage stability at 95 percent.
Shi Zihai, deputy head of the administration, said a key priority is to boost enrollment among flexible workers, migrant laborers and those in new forms of employment.
Huang Huabo, another deputy head of the administration, noted that more than 6.98 million flexible workers had joined the medical insurance system by 2025, a 5.54 percent year-on-year increase.
The administration, together with six other ministries, has issued a special action plan to remove residency restrictions on enrollment and allow monthly or flexible premium payments — making it easier for mobile workers to maintain coverage, he said.
On maternity insurance, Wang Wenjun, deputy head of the administration, said the number of insured people under maternity schemes has reached 260 million, and in the first seven months of this year, benefit payouts totaled 78.4 billion yuan ($11.7 billion), with maternity allowances now paid directly to individuals.
For long-term care insurance, Wang revealed that 22 provincial regions have issued implementation plans, covering over 320 million participants. By the end of 2028, the system is expected to cover the entire country, extending from urban employees to urban and rural residents, with unified disability assessment standards and wider mutual recognition across regions, she said.
Li Tao, deputy head and spokesman of the administration, emphasized support for innovation. Since 2018, the dynamic adjustment mechanism has added 949 drugs to the national catalog, including 199 innovative ones.
During the 15th Five-Year Plan period, the administration will continue annual catalog updates to include more innovative drugs for cancer, rare diseases, chronic conditions and child health, she said.
At the same time, it will work toward a unified national reimbursement list for medical services and consumables — currently determined by provincial regions — to reduce regional disparities, she said.
The administration will also expedite pricing approvals for new technologies and implement special case review mechanisms to ensure hospitals are not penalized for using novel therapies in complex cases, she added.
On bulk procurement, Shi said that 12 national rounds have covered 555 drugs and six rounds have covered 142 types of high-value consumables.
Huang said big data and artificial intelligence will be deployed for proactive risk detection, while special probes will target fraud in maternity benefits and long-term care — such as fabricated disability assessments or bogus service claims.
The goal, he said, is to build a comprehensive, multilayered regulatory framework that combines deterrence, smart monitoring and institutional safeguards to protect the “lifesaving money” of the insured. –The Daily Mail-China Daily news exchange item
