Approximately three years to cover the entire population! The National Healthcare Security Administration responds to every question: By the end of 2028, the long-term care insurance system will be basically fully covered nationwide.

Reporter from 每经｜Zhou Yifei    Editor-in-Chief of 每经｜Bi Luming

On March 26, the State Council Information Office held a press conference to introduce developments related to accelerating the establishment of a long-term care insurance system.

A reporter with The Daily Economic News noted that recently the General Office of the CPC Central Committee and the General Office of the State Council officially released the “Opinions on Accelerating the Establishment of a Long-Term Care Insurance System” (hereinafter referred to as the “Opinions”). Long-term care insurance is a new type of insurance within social insurance. It is funded by having everyone enroll and contribute premiums, and it provides basic living care and medical nursing for insured people who have lost the ability to carry out normal activities. Nursing expenses incurred are reimbursed.

The “14th Five-Year Plan” outline clearly states that long-term care insurance will be rolled out. What are the specific timetable and roadmap for establishing the system nationwide?

Photo source: Reporter from 每经, Zhou Yifei

When answering the reporter’s above questions from The Daily Economic News, Wang Wenjun, deputy director of the National Healthcare Security Administration, said that it will take about three years to basically establish a long-term care insurance system that fits China’s basic national conditions. By the end of 2028, the relevant system should be basically fully covered across the country.

It can start with pooling at the prefecture-level and city-level, or it can explore provincial-level pooling according to local conditions.

Wang Wenjun further told reporters from The Daily Economic News that the “14th Five-Year Plan” outline clearly requires the rollout of long-term care insurance. The specific timetable and roadmap are reflected in the “3-year” target stipulated in the “Opinions.” In other words, it will take about three years to basically establish a long-term care insurance system that fits China’s basic national conditions; by the end of 2028, this system should be basically fully covered nationwide.

In terms of pooling levels, it can start with pooling at the prefecture-level and city-level, or provincial-level pooling can be explored based on local actual conditions. In the near term, Hainan Province has already released a program for establishing the system, and what it is exploring is provincial-level pooling.

On the pace of implementation, each province will determine it based on actual conditions. Reforms will be advanced in steps and in batches. Cities with the relevant conditions can move first, while those without the conditions can consolidate the conditions and then implement. No “one-size-fits-all” and no “cutting once and for all.”

In terms of covered populations, it can start with employees, then gradually expand coverage to urban and rural residents. Alternatively, employees and urban and rural residents can be included in the coverage scope of the system at the same time.

“For the original pilot areas, the 92 pilot regions should adjust and improve their policies according to the requirements in the ‘Opinions’ and gradually align with the national requirements. That is to say, by the end of 2028, there should be a basically smooth transition. To ensure the stability of benefit protection for people in the original pilot areas, for some pilot practices that align with the direction of system development, there is no need for rigid adjustments,” Wang Wenjun emphasized.

Ministry of Finance: Will promote the steady rollout and implementation of the long-term care insurance system

The long-term care insurance system is a new and important institutional arrangement in the area of people’s wellbeing. What measures has the financial department taken to accelerate the establishment of a long-term care insurance system?

Guo Yang, director of the Social Security Department of the Ministry of Finance, said that implementing the long-term care insurance system is an important measure to address the care difficulties of people with disabilities and further weave and strengthen the social security safety net. The Ministry of Finance has taken a series of measures to actively support the establishment and implementation of the long-term care insurance system.

First, it explores and accumulates experience through pilots. The Ministry of Finance works with the National Healthcare Security Administration to guide pilot regions in improving policy design and to explore establishing a premium-funding mechanism with reasonable cost-sharing by all parties. In pilot regions, the enrollment scope starts with employee groups. For regions with conditions, it is further expanded to residents. To support enrollment, pilot regions, based on their own circumstances, study and formulate relevant fiscal subsidy policies, including providing subsidies to enrolled residents and providing assistance to enrolled people facing enrollment difficulties, among others. All of this provides beneficial experience for the central level to develop and introduce policies.

Second, it clarifies that the government provides subsidies for residents’ enrollment. Based on summarizing pilot work, the Ministry of Finance works with the National Healthcare Security Administration to strengthen top-level design and to promote the construction of a nationwide unified long-term care insurance system. The “Opinions” and the implementation plans of eight departments specify that it is necessary to establish and improve a diversified premium-funding channel involving units, individuals, the government, and society. For enrolled urban and rural residents, the government provides subsidies in accordance with regulations. On this basis, the government also provides classified subsidies for people facing difficulties—such as those in extreme poverty and people eligible for minimum living allowance.

“These subsidy funds are jointly borne by the central government and local governments. In the 2026 central-to-local transfer payment budget, we have already made the corresponding arrangements. Considering that enrollment work by residents in different localities will be rolled out gradually, this year the central government’s fiscal subsidies for localities will be advanced based on the number of enrolled residents expected in each locality. Then, in the next budget year, the funds will be settled based on the actual number of enrolled residents, to ensure subsidies are disbursed in full. Going forward, as the number of enrolled people increases, the intensity of fiscal subsidies will continue to be increased,” Guo Yang emphasized.

Third, it strengthens fund management and oversight. The “Opinions” and the implementation plans by eight departments both contain clear provisions. Like other social insurance funds, the long-term care insurance fund must be set up with its own ledger, managed separately, and used for its designated purposes only. It must also be clearly incorporated into the scope of social insurance fund budget preparation, requiring scientific preparation of fund revenue and expenditure budgets and strengthening budget performance management.

Guo Yang said that currently, the Ministry of Finance is researching and formulating, together with relevant departments, the financial management measures for the long-term care insurance fund and the management measures for fiscal subsidy funds. It will further strengthen fund financial budgeting and clarify the specific processes and oversight and management requirements for the allocation, issuance, use of fiscal subsidy funds, and compress responsibilities across all levels to provide institutional guarantees for the safe, compliant, and efficient use of funds.

In the next step, the Ministry of Finance will earnestly implement the decisions and deployments of the CPC Central Committee and the State Council, guide local finance departments to promptly and in full arrange fiscal subsidy funds, strengthen financial and accounting oversight, and promote the steady rollout and implementation of the long-term care insurance system. This will ensure that policy dividends can promptly and efficiently benefit every eligible insured person, and will effectively reduce the care burden on families of people with disabilities.