China Details 15th Five-Year Plan for Universal Healthcare Coverage

China's National Healthcare Security Administration has released its 15th Five-Year Plan for Universal Healthcare Security, establishing a strategic roadmap toward 2030 to build a multi-tiered, sustainable healthcare framework. The plan introduces eight core development targets, adding new metrics such as expanding long-term care insurance regions, tracking fund reserve sustainability, raising real-time settlement rates, and disbursing maternity allowances directly to individuals. It also aims to achieve provincial-level fund pooling across China by 2029 while steering reimbursement incentives toward grassroots medical facilities.

The blueprint defines China's healthcare reforms amid deepening population aging and fiscal pressures on insurance reserves. By instituting concrete performance metrics—such as direct maternity subsidies, long-term care expansion, and provincial pooling by 2029—authorities aim to mitigate regional disparities, improve financial stability, and encourage synergy between statutory coverage and commercial insurance.

China's National Healthcare Security Administration (NHSA) has released the 15th Five-Year Plan for Universal Healthcare Security, setting the policy blueprint for national healthcare reforms through 2030, according to state media reports. The plan aims to establish a comprehensive, multi-tiered medical security framework that balances urban and rural needs while ensuring financial safety and institutional sustainability. To steer reform during the 15th Five-Year period, the NHSA established eight primary indicators with concrete target values. According to an NHSA official cited by Xinhua, the new indicators specifically address macroeconomic trends, aging demographics, and systemic governance needs. Key newly introduced metrics include expanding the number of pooled regions covered by long-term care insurance, monitoring the payable reserve months of employee and resident basic health insurance pooled funds, increasing the coverage rate of real-time settlement for medical insurance expenditures, and directly disbursing maternity allowances to individual beneficiaries. Under the framework, statutory basic medical insurance remains the core foundation, supported by critical illness insurance and basic medical assistance. The plan calls for optimizing financing mechanisms by balancing the contribution burdens among individuals, employers, and government subsidies. To optimize resource allocation, reimbursement policies will deliberately favor primary healthcare facilities by widening the gap in inpatient reimbursement rates between grassroots clinics and higher-tier hospitals. Additionally, authorities will standardize outpatient coverage for chronic and special diseases within provinces. A major structural milestone in the plan is achieving basic provincial-level pooling of healthcare funds by 2029, aimed at strengthening fund risk resistance and utilization efficiency. Beyond the basic statutory tier, the NHSA pledged to foster commercial medical insurance, charitable donations, and mutual aid mechanisms to address uncovered healthcare expenses and ease out-of-pocket costs for residents.