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China is planning to broaden its maternity insurance coverage next year to include a significant number of freelancers without permanent jobs, aiming to combat the declining birth rate and ease the pressures of an aging population.
The national health insurance system will proactively adapt to the country’s demographic strategy by promoting maternity and long-term care insurance. During a recent work conference held in Beijing, officials outlined plans to extend maternity insurance to individuals working flexible jobs, migrant workers, and those engaged in new employment models next year. The goal is to make childbirth virtually free of personal expenses nationwide.
Currently, maternity insurance mainly benefits employees of companies, paid for by their employers, with no contributions required from workers. The insurance provides two primary benefits: reimbursements for all pregnancy and childbirth-related costs—including prenatal visits, hospital deliveries, surgeries, and medications—and a maternity allowance that offers women a basic income during their leave.
Last year, approximately 253 million people in China participated in maternity insurance, representing a 1.6% increase from the previous year, according to data from the National Healthcare Security Administration. About 36.9 million individuals received maternity benefits, a 30% rise, while the fund’s expenditure surged by 19% to 140.3 billion yuan (roughly $19.9 billion).
In recent years, China’s rapidly expanding digital economy has spurred tremendous growth in gig economy workers, such as food delivery personnel, ride-hailing drivers, and social media content creators. By the end of last year, there were approximately 240 million flexible workers, making up about 31% of the total employed population, according to the National Bureau of Statistics.
Several local governments have already taken steps to expand maternity insurance coverage to promote childbirth. For example, in February, Shanghai announced that freelancers enrolled in the city’s basic health insurance scheme would also be covered by maternity insurance.
Since 2022, China’s population has declined for three consecutive years, with birth rates reaching historic lows. The country recorded approximately 9.54 million births last year, an increase of 520,000 from 2023 and marking the first rise since 2017. However, the number of newborns still fell short of deaths, resulting in a net population decline of 1.39 million.
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