The National Healthcare Security Administration dismisses the decline in voluntary participation in the urban and rural residents’ scheme as a “minor fluctuation.” Meanwhile, personal contributions have increased almost fortyfold over the past twenty years, leading some to question the scheme’s cost-effectiveness.
China’s state health insurance regulatory body is urging increased enrollment from rural areas while downplaying concerns about declining participation rates.
Addressing the recent decrease in participants in the program tailored for farmers and the unemployed, the National Healthcare Security Administration (NHSA) attributed the decline to technical enhancements and structural adjustments. This rationale comes amidst reports and research indicating diminished enthusiasm for the program due to escalating premiums and stagnant incomes amid economic slowdown.
A decrease in participation poses additional challenges for China’s health insurance system, already strained by rapid population aging and workforce contraction.
The NHSA refuted claims of a widespread exodus from the voluntary urban and rural residents’ scheme, covering over 70% of China’s 1.4 billion population, one of two schemes within the state health insurance system.
Although approximately 25 million individuals exited the scheme in 2022, the NHSA characterized this as a “minor fluctuation.” The administration attributed the fluctuation primarily to the allowance of cross-provincial reimbursements since 2022, prompting many to consolidate their plans from multiple provinces into one.
Previously, policyholders could only claim expenses in one province, leading many migrant workers to enroll in multiple schemes before the 2022 reform.
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