China approved, for the first time, a law dedicated to the health insurance system that covers 1.33 billion people (95% of the population), with at least three main changes: the collective purchase of medicines as a legal obligation, the formal incentive to include informal workers in the health plan of formal workers and the creation of the legal duty to establish long-term care insurance for the elderly and people with disabilities throughout the national territory.
The Medical Security Law of the People’s Republic of China was approved on August 28 by the Standing Committee of the National People’s Congress (NPC) and signed by President Xi Jinping through Presidential Decree No. 80. The rule will come into force on January 1, 2027.
In a press conference this Friday (4) to address the changes to the new law, the deputy director of the National Medical Security Administration (ANSM), Shi Zihai, stated that the institution is following the instructions of Xi Jinping, as general secretary of the Communist Party of China (CPC), to “eliminate the people’s concerns about medical costs and care” and to follow the people-centered development philosophy.
Collective purchasing of medicines is a mechanism through which the State pools demand from all public hospitals, organizes tenders on a national scale and offers manufacturers stable supply contracts in exchange for lower prices, reducing the cost of medicines for the population. Article 26 determines that the State must “establish and improve the collective purchasing system for medicines and medical supplies”. The practice already existed as administrative policy, but will now gain greater weight as law.
Since 2018, the central government has carried out 12 rounds of purchases, acquiring 555 drugs. In the same period, it did six rounds for high-value medical devices and covered 142 items, according to Shi.
Informal workers
Article 10 of the law encourages self-employed workers without employers, part-time workers not linked to the formal worker plan and “other workers in flexible employment” to join the formal worker plan. This process is already happening; in 2025, 69.82 million informal workers were in the formal workers’ plan, an increase of 5.54% compared to the previous year, according to Huang Huabo, deputy director of ANSM.
The law complements the Five-Year Universal Health Coverage Plan for 2026–2030, also recently presented by the National Health Insurance Administration of China, which determines that digital platforms must cover part of the contribution of delivery drivers, app drivers and on-demand service providers.
The formal workers’ plan guarantees reimbursement of approximately 80% of hospital expenses within the list of covered procedures and medications, compared to 70% under the plan for urban and rural residents.
Maternity and long-term care
Article 14 makes the participation of formal workers in maternity insurance mandatory, with contributions paid exclusively by the employer, and determines that the State must “promote the expansion of maternity insurance coverage”.
Article 15 extends maternity insurance coverage to non-working spouses. Until now, in China, only the contributing worker had reimbursement for childbirth costs and maternity benefits in cash; the unemployed spouse was left without coverage. With the law, this spouse now has the right to reimbursement for medical expenses, but not to cash assistance, which remains exclusive to those who contribute.
Currently, 260 million have maternity insurance, and 28 of China’s 31 provincial administrative units already cover hospital births free of charge, according to Wang Wenjun, deputy director of ANSM.
Article 55, in the final provisions chapter, determines that the State “establishes and improves the long-term care insurance system” for the elderly and people with severe disabilities. ANSM must regulate, together with other ministries, this provision.
The goal is to achieve national coverage by the end of 2028, according to Wang Wenjun. The system has been operating in a pilot phase since 2016, covers more than 320 million people and has so far benefited more than 4.6 million people with severe disabilities.
Source: www.brasildefato.com.br
