China has further expanded health insurance coverage, with official figures showing that more than 1.3 billion people were enrolled in medical insurance schemes by the end of last year, bringing coverage to roughly 95 per cent of the population.
Data released on Monday by the National Healthcare Security Administration show that China’s medical insurance system covered about 1.33 billion people at the end of 2025, combining public basic insurance with supplementary private plans.
The expansion comes amid significant public health gains in China over recent decades, as rising incomes lifted hundreds of millions out of poverty.
Average life expectancy reached 79 in 2024, broadly in line with the United States (US), however, benefits remain uneven, funding varies by province, and access gaps persist, particularly between urban and rural areas.
China’s basic medical insurance system is divided into two main programmes, an urban employee scheme funded largely through payroll contributions, and a resident programme covering children, the unemployed and rural populations, which relies more heavily on government subsidies.
According to the report, 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 per cent.
The national medical insurance fund, which includes maternity coverage, recorded revenue of about 3.59 trillion yuan (approximately $520 billion), while expenditures totalled around 3 trillion yuan.
Maternity insurance enrolment increased by more than 6.6 million people compared with 2024, bringing total participation to over 35 million.
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From last year, insurance coverage was also extended to certain assisted reproductive services, including artificial insemination and egg retrieval.
More than 3 million people received insurance support for such treatments, benefiting over 1.6 million patients nationwide.
Reports added that by the end of 2009, China’s basic medical insurance covered just over 1.2 billion people, driven largely by the nationwide rollout of rural cooperative insurance.
At that time, around 400 million people were enrolled in urban schemes, while about 814 million were covered under the rural system, which offered lower reimbursement levels.
For comparison, about 92 per cent of the US population, roughly 310 million people, had health insurance coverage for at least part of 2024.
Private, mainly employer-based insurance covered around two-thirds of Americans, while public programmes such as Medicare and Medicaid accounted for about a third, leaving around 8 per cent uninsured.
Despite China’s high headline coverage rate, questions remain over the depth of protection.
A December 2024 report by the World Bank Group said many low-income and vulnerable middle-income households rely on the subsidised resident programme, which excludes several cost elements and offers limited financial protection.
The report added that fully consolidating the employee and resident schemes, with equal benefits, would be a key step towards more comprehensive universal health coverage.
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