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 Minglu

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 social insurance. By having everyone enroll and pooling funds, it provides basic daily living assistance and medical nursing care for insured persons who have lost the ability to carry out normal activities, and reimburses the long-term care expenses incurred.

The “14th Five-Year Plan” outline clearly calls for promoting long-term care insurance. What is the specific timeline and roadmap for establishing the system nationwide?

Image source: Daily Economic News reporter Zhou Yifei, photo

Wang Wenjun, deputy director of the National Healthcare Security Administration, answered the above question from a reporter of the Daily Economic News by saying that it will take about 3 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 comprehensively covered nationwide on a basic level.

It can start with overall planning at the city level, or it can explore overall planning at the provincial level depending on local conditions.

Wang Wenjun further told the Daily Economic News reporter that the “14th Five-Year Plan” outline clearly requires the promotion of long-term care insurance. The specific timeline and roadmap are reflected in the “3-year” target specified in the “Opinions.” That is, with about 3 years, a long-term care insurance system adapted to China’s basic national conditions will basically be established, and by the end of 2028, this system should be comprehensively covered nationwide on a basic level.

From the perspective of the planning level, it can start with overall planning at the city level, or it can explore overall planning at the provincial level depending on local conditions. Recently, Hainan Province has already released a scheme for establishing the system, and the approach being explored there is provincial-level overall planning.

In terms of the implementation pace, the specific steps are determined by each province based on actual conditions. Reforms should be advanced in phases and batches. Cities that have the conditions can move first; those that do not should consolidate their conditions first before implementation. No “one-size-fits-all,” and no “cut-and-dried” approach.

In terms of the coverage population, it can start with the workforce population first, and then gradually expand coverage to urban and rural residents. Or it can include both the workforce population and urban and rural residents into the coverage scope of the system at the same time.

“For the original pilot areas, the 92 pilot areas need to adjust and improve the policies in accordance with the ‘Opinions,’ and gradually align them with the provisions set by the state. That means that by the end of 2028, a basically smooth transition will be achieved. 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 push for 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 livelihoods. What measures has the finance department taken to accelerate the establishment of the 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 solve the problem of care difficulties for persons who have lost functional ability, and further to weave a tighter and sturdier social security safety net. The Ministry of Finance has taken a series of initiatives to actively support the establishment and implementation of the long-term care insurance system.

First, explore and accumulate experience through pilot programs. The Ministry of Finance, together with the National Healthcare Security Administration, has guided pilot areas to improve policy design, and explored mechanisms for financing with reasonable cost-sharing among all parties. The insured enrollment scope in pilot areas begins with the workforce population; in areas with conditions, it is further expanded to residents. To support enrollment, the pilot areas, based on their own realities, have researched and formulated relevant fiscal subsidy policies, including subsidies for insured residents and funding for insured persons with enrollment difficulties, among others. These have accumulated useful experience for policy formulation at the national level.

Second, clarify that the government provides subsidies for resident enrollment. Based on summarizing the pilot work, the Ministry of Finance, together with the National Healthcare Security Administration, has strengthened top-level design and promoted the building of a nationwide unified long-term care insurance system framework. The “Opinions” and the implementation plans of eight departments clarify that it is necessary to establish and improve a diversified financing channel involving work units, individuals, the government, and society. For insured urban and rural residents, the government provides subsidies in accordance with regulations. On that basis, the government also provides classified subsidies for difficult groups such as people in need with special hardship, and persons eligible for the minimum living allowance.

“These subsidy funds are jointly borne by the central government finance and local government finance. In the 2026 central budget for transfer payments to localities, we have already made corresponding arrangements. Taking into account that enrollment work by residents in different places will gradually be rolled out, this year the central government will make advance payments of subsidies to localities based on the number of insured residents that each region is expected to enroll. Then, in the next fiscal year, it will make final settlement based on the actual number of insured residents, to ensure that subsidy funds can be paid in full. Going forward, as the number of enrolled people increases, the level of fiscal subsidies will continue to be increased as well,” Guo Yang emphasized.

Third, strengthen fund management and oversight. The “Opinions” and the implementation plan of eight departments both make clear provisions that, like other social insurance funds, the long-term care insurance fund must be set up with separate accounts, managed separately, and earmarked for specific use. It is also required that the long-term care insurance fund be included within the budget scope of social insurance funds, that the fund revenue and expenditure budgets be scientifically formulated, and that budget performance management be strengthened.

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 fiscal subsidy fund management measures. It will further strengthen budget management for fund finances, clarify the specific procedures for distribution, issuance, use, and oversight requirements for fiscal subsidy funds, and ensure that responsibilities at all levels are firmly in place, providing institutional guarantees for the safe, standardized, and efficient use of funds.

Next, the Ministry of Finance will earnestly implement the decision-making and deployment of the CPC Central Committee and the State Council, guide local finance departments to timely and adequately allocate fiscal subsidy funds, strengthen financial and accounting supervision, and promote the steady rollout and implementation of the long-term care insurance system. This will ensure that policy dividends can be delivered in a timely and efficient manner to every insured person who meets the eligibility criteria, and will effectively reduce the burden on families of people with lost functional ability in caring for them.