China Considers Medical Insurance Law Revisions to Strengthen Healthcare System

Chinese lawmakers are currently considering a revised draft of the medical insurance law. The aim is to enhance the nation's fundamental healthcare insurance system and improve access to medical services.

Key aspects of the draft include expanding coverage to include gig workers, modifying reimbursement policies during outbreaks of acute diseases, and strengthening the oversight of fund management. The draft was presented to the Standing Committee of the National People's Congress for its initial review.

According to Zhang Ke, director of the National Healthcare Security Administration, China has been actively reforming its medical insurance system in recent years. The proposed law is intended to formalize these reforms and consolidate existing rules and regulations. The draft establishes a dedicated section that systematically outlines the healthcare security system's structure, providing clear guidelines on coverage, funding, and benefits for established insurance programs.

For programs that are still developing, such as those providing assistance for high medical expenses and critical illness insurance, the draft allows local authorities to create specific implementation plans. The draft also encourages self-employed, part-time, and gig workers to participate in the basic employee insurance program. Furthermore, the nation plans to broaden the scope of maternity insurance, gradually including flexible workers enrolled in the basic program.

Drawing from experiences during past infectious disease outbreaks, the draft allows the top healthcare insurance authority to propose changes to insurance reimbursement policies in collaboration with other government departments. Zhang emphasized the importance of strengthening oversight of insurance fund management, including establishing channels for supervision and whistleblowing involving lawmakers, government agencies, and the public. Stricter penalties, such as fines, suspension of medical services, and termination of service agreements, are proposed for illegal activities.

By the end of 2024, China's basic medical insurance program covered nearly 1.33 billion people, with a consistent participation rate of 95 percent. The number of people enrolled in the maternity insurance program increased by 3.9 million year-on-year, reaching 253 million by the end of last year.