At a national medical insurance work conference held in Beijing over the weekend, Zhang Ke, Party Secretary and Director of the National Healthcare Security Administration (NHSA), outlined ambitious plans to make childbirth expenses nearly free for policyholders across the country.
According to The Paper, Zhang announced that by 2026, China will proactively align its medical insurance framework with the nation’s population development strategy, prioritizing the expansion of maternity insurance and the establishment of long-term care insurance. A key focus will be broadening maternity insurance coverage to include flexible workers, migrant laborers, and those in emerging employment models.
To ease the financial burden of childbirth, Zhang revealed that coverage for prenatal check-ups will be raised appropriately, targeting nationwide elimination of out-of-pocket payments for childbirth-related costs covered by medical insurance. Additionally, approved labor pain relief services will be incorporated into medical insurance reimbursements following established procedures.
Highlighting progress to date, Zhang noted that China has significantly improved coverage for inpatient childbirth expenses in recent years, actively pushing for full reimbursement of policy-covered maternity medical costs. Leading the charge, seven provinces—including Jilin, Jiangsu, and Shandong—have already achieved near-zero personal spending on childbirth. “Our vision is that from the moment a pregnant woman is admitted to the hospital until she departs with her newborn, insured individuals will essentially incur no out-of-pocket costs for inpatient delivery expenses listed in the medical insurance catalog,” he explained.
The NHSA also pledged to streamline maternity allowance disbursements, ensuring direct payments to insured individuals in line with regulations, while accelerating the rollout of a comprehensive long-term care insurance system and enhancing the availability of related services. Commercial insurers will be incentivized to create specialized long-term care insurance products.
Looking ahead to 2026, Zhang emphasized reforms to medical insurance payment and settlement mechanisms to foster a healthier healthcare ecosystem. Key initiatives include rolling out Version 3.0 of the Diagnosis-Related Group (DRG) payment classification plan, conducting quarterly or monthly reviews of exceptional cases, and supporting the clinical adoption of innovative drugs, medical supplies, and technologies, as well as treatments for complex and critical illnesses.
Further efforts will bolster primary healthcare institutions and advance tiered diagnosis and treatment systems. The administration plans to increase prepayments of medical insurance funds, fully implement real-time settlement, explore quarterly settlement options, and finalize 40 sets of pricing guidelines to standardize medical service pricing items nationwide.
