Health care coverage in China continued its steady expansion last year, with more than 1.3 billion people enrolled in medical insurance, according to official data.
The country of 1.4 billion has made major public health gains over recent decades as rising incomes have lifted hundreds of millions out of poverty, pushing average life expectancy to 79 in 2024, on par with the United States.
But benefits remain limited, funding varies by province, private care plays a growing role, and access gaps persist, especially between urban and rural areas. Newsweek reached out to the Chinese Foreign Ministry via email for comment.
China’s medical insurance system, comprising public basic insurance and supplementary private coverage, covered 1.33 billion people, or about 95 percent of the population, at the end of 2025, according to a report released Monday by the country’s National Healthcare Security Administration.
The basic system is split into two main programs: an urban employee program funded by payroll contributions, and a resident program covering children, persons who are not formally employed, and rural populations, which is more heavily government-subsidized.
The number of outpatient visits covered under basic medical insurance rose by more than 7.21 billion year on year, an increase of 25.51 percent.
The national medical insurance fund, which includes maternity coverage, brought in about 3.59 trillion yuan (roughly $520 billion) in revenue, while expenditures totaled around 3 trillion yuan, according to the administration.
Maternity insurance enrollment rose by more than 6.6 million people from 2024, bringing total participation to over 35 million.
Starting last year, China expanded coverage to include a range of assisted reproductive services, such as artificial insemination and egg retrieval.
More than 3 million people received insurance support for such treatments, benefiting over 1.6 million patients nationwide, the report said.
China’s basic medical insurance system covered more than 1.2 billion people by the end of 2009, driven primarily by the earlier nationwide expansion of rural cooperative insurance.
At that point, roughly 400 million people were enrolled in urban basic medical insurance, while about 814 million were covered under the rural cooperative system, which offered more basic, lower-reimbursement coverage aimed at farmers and rural residents.
By comparison, about 92 percent of the U.S. population, or roughly 310 million people, had health insurance coverage for at least part of 2024.
Private insurance, largely employer-based, covered around two-thirds of Americans, while public programs such as Medicare and Medicaid covered about a third. Around 8 percent of the population remained uninsured.
A December 2024 report by the World Bank Group says: “Many households in the low income and vulnerable middle segments are reliant on insurance provided through the subsidized resident program.
The financial protection provided through this program is limited as many cost elements are excluded. This exposes many households to the risk of catastrophic health expenditure.
“Furthermore, the employee program and the resident program are run in parallel. Consolidating them fully with parity in benefits will be a key step toward universal health coverage.”
(Miami Herald)
