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.

Daily Economic News reporter | Zhou Yifei    Daily Economic News editor | Bi Luming

On March 26, the State Council Information Office held a press conference to brief on efforts to accelerate the establishment of a long-term care insurance system.

A reporter from the Daily Economic News noted that recently, the General Office of the CPC Central Committee and the General Office of the State Council officially issued 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 the social insurance system. By having everyone enroll and contribute to the fund, it provides basic living assistance and medical nursing care for insured persons who have lost the ability to perform normal activities, and reimburses eligible nursing care expenses.

The outline of the “15th Five-Year Plan” (for the years 2026–2030) clearly calls for promoting long-term care insurance. What is the specific timetable and roadmap for establishing the system nationwide?

Image source: Daily Economic News reporter Zhou Yifei

Wang Wenjun, deputy director of the National Healthcare Security Administration, responded to the aforementioned question from a Daily Economic News reporter by saying 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 related system will be basically fully covered nationwide.

It can start with overall coordination at the municipal/prefecture level, or it can explore overall coordination at the provincial level depending on local conditions.

Wang Wenjun further told a Daily Economic News reporter that the outline of the “15th Five-Year Plan” clearly requires promoting long-term care insurance, and the specific timetable and roadmap are reflected in the “3-year” target specified 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, and by the end of 2028, this system should be basically fully covered nationwide.

From the perspective of coordination level, it can start with overall coordination at the municipal/prefecture level, or it can explore overall coordination at the provincial level depending on local actual conditions. Recently, Hainan Province has already issued a system establishment plan; what it is exploring is overall coordination at the provincial level.

In terms of implementation pace, the specific schedule will be determined by each province according to its actual situation. Reforms will be advanced step by step and in batches. Cities with conditions can move first; cities without conditions can consolidate conditions first and then implement. No “one synchronized move,” and no “one-size-fits-all” approach.

In terms of coverage scope, it can begin with the population of employed persons, and then gradually expand coverage to urban and rural residents; it can also bring employed persons and urban-rural residents into the coverage of the system at the same time.

“For the original pilot areas, the 92 pilot areas need to adjust and improve policies in accordance with the ‘Opinions,’ and gradually align with the national requirements. That is to say, by the end of 2028, we will basically achieve a smooth transition. To ensure the stability of benefits for the people in the original pilot areas, for some pilot practices that are in line with the direction of system development, there is no need for mandatory adjustments.” Wang Wenjun emphasized.

Ministry of Finance: Will推动 long-term care insurance system to be steadily implemented

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

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

First, accumulate experience through pilot exploration. The Ministry of Finance, together with the National Healthcare Security Administration, guides pilot regions to improve policy design, and explores the establishment of a financing mechanism in which relevant parties share responsibility in a reasonable manner. In pilot regions, the scope of enrollment starts with employed people; in areas with conditions, it is further expanded to include residents. To support enrollment, pilot regions, based on their own actual circumstances, have researched and formulated relevant fiscal assistance policies, including providing subsidies to enrolled residents and offering funding support to enrollment-difficulty groups, among others. All of this has accumulated useful experience for formulating and issuing policies at the national level.

Second, clarify that the government provides subsidies to residents who enroll. Based on summarizing pilot work, the Ministry of Finance, together with the National Healthcare Security Administration, strengthens top-level design and promotes the construction of a nationwide unified long-term care insurance system framework. The “Opinions” and the implementation plans from eight departments make it clear that it is necessary to establish and improve a diversified financing channel involving work units, individuals, the government, and society. For enrolled urban and rural residents, the government provides subsidies in accordance with regulations. On that basis, the government also provides categorized subsidies for people facing difficulties, such as those in extreme poverty and recipients of minimum living allowances.

“Those subsidy funds are jointly borne by the central government and local governments. In the 2026 central government budget for transfer payments to localities, we have already made corresponding arrangements. Considering that enrollment by residents will be gradually rolled out, this year the central government will pre-allocate subsidies to localities based on the number of enrolled residents expected in each locality, and then, in the next budget year, conduct final settlement based on the actual number of enrolled residents to ensure that subsidy funds are paid out 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, strengthen fund management and supervision. The “Opinions” and the implementation plans from eight departments both make clear provisions that the long-term care insurance fund, like other social insurance funds, must set up separate accounts, be managed separately, and be earmarked for specific purposes. They also clarify that the long-term care insurance fund should be included within the budget compilation scope for social insurance funds, requiring scientific budget compilation for fund revenues and expenditures and strengthening budget performance management.

Guo Yang said that currently, the Ministry of Finance is working with relevant departments to study and formulate financial management measures for the long-term care insurance fund and management measures for fiscal subsidy funds. It will further strengthen fund financial budget management, clarify the specific process requirements for the allocation, issuance, use, and supervision of fiscal subsidy funds, and strengthen accountability at all levels, to provide institutional safeguards for secure, standardized, and efficient use of funds.

In the next step, the Ministry of Finance will conscientiously implement the decision-making and deployment of the CPC Central Committee and the State Council, guide local finance departments to promptly and sufficiently arrange fiscal subsidy funds, strengthen financial and accounting oversight, and promote the steady implementation of the long-term care insurance system on the ground. This will ensure that policy benefits can reach every eligible insured person in a timely and efficient manner, and effectively reduce the caregiving burden on families of people with functional impairments.