China expands long-term care insurance for elderly

China will expand its long-term care insurance program nationwide in the coming years, with supporting policies to address rising needs for elder and disability care amid rapid aging, according to the National Healthcare Security Administration. Piloted since 2016 in 49 cities, it now covers nearly 300 million people.

China faces rapid population aging. By the end of 2024, the number of people aged 60 and above reached 310 million, accounting for 22 percent of the total population, and is projected to hit 400 million by 2035. Around 35 million seniors live with disabilities, representing 11.6 percent of the elderly population, with projections rising to 46 million by 2035.

To address this, the National Healthcare Security Administration announced at a recent conference in Ningbo, Zhejiang province, that the long-term care insurance program has benefited over 3.3 million people with disabilities, with cumulative spending exceeding 100 billion yuan ($14.3 billion). During the 14th Five-Year Plan period (2021-25), it has reduced nursing care expenses by more than 60 billion yuan.

The program covers costs for daily living assistance for the elderly, such as help with eating and bathing, along with basic medical services and routine wound care for those with disabilities. It has not only eased financial burdens but also boosted the elderly care service sector. Since 2021, more than 50 billion yuan in social capital has been invested in related fields across the 49 pilot cities. The number of designated long-term care institutions has surpassed 8,800, and the nursing professional workforce has grown to about 300,000—both increases of over 50 percent since early 2021.

The annual Central Economic Work Conference in December highlighted the need to expand rehabilitation and care services, promote the long-term care insurance system, and bolster support for vulnerable groups. The administration plans to accelerate the development of a long-term care insurance system with Chinese characteristics over the next five years, initially focusing on those with severe disabilities and gradually achieving nationwide coverage. It will also standardize regulations on financing, benefits, and payments to ensure high-quality, sustainable development.

In an interview with China Health Insurance magazine, Xu Jing, an official with the administration, stated: "Standardization is essential to ensure the effective operation and long-term sustainability of the system." She added that unified policies would eliminate the need for heavy investments to comply with varying regional regulations, reducing transaction costs. A standardized, transparent, and unified regulatory framework would also stabilize market expectations, attract more social capital, and promote efficient resource allocation.

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