CHINA

China’s Medical Insurance Fund Stabilizes as Revenue Outpaces Spending

Published: Jul. 8, 2026 12:36 p.m. GMT+8

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China's state medical insurance revenue grew faster than spending in 2025, reversing a yearslong trend that had threatened the fund's stability amid a rapidly aging population.

The National Healthcare Security Administration disclosed demographic and health-insurance data spanning from 1998 to 2025 on July 6, highlighting 30 years of system reforms. In a notable shift, the insurance fund reported 2025 revenue grew by 95.97 billion yuan ($14.12 billion), a 2.7% increase from the previous year.

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In 2025, China's medical insurance revenue grew 2.7% (95.97 billion yuan), outpacing expenditure growth of 0.8% (24.53 billion yuan), reversing a yearslong trend.
The worker-to-retiree ratio fell to 2.6 in 2025 (down 36.5% since 1998), while life expectancy reached 79.25 years, straining the fund long-term.
Out-of-pocket cash payments dropped from 55.85% (1998) to 27.51% (2024), and enrollment recovered to 1.331 billion in 2025.

AI generated, for reference only

What Happened When

1998：: China's worker medical insurance system established; worker-to-retiree ratio at 4.09; total health expenditure at 367.87 billion yuan; out-of-pocket cash payments at 55.85% of total healthcare spending; hospital revenue from state insurance less than 2%.

2004：: Rural and urban resident medical insurance rollouts began.

2010：: Period of comprehensive coverage began.

2018：: National Healthcare Security Administration established; beginning of final era in system history.

2021：: Spending growth at 14.3%.

2022：: Spending growth at 2.3%; launch of unified national information platform; total enrollment dips to 1.345 billion.

2023：: Spending growth at 14.7%; fund balance shrinks by 103.06 billion yuan; total enrollment settles at 1.333 billion; 23 new medications added to insurance directory.

2024：: Spending growth at 5.5%; fund balance shrinks by 14.5 billion yuan; total enrollment at 1.326 billion; out-of-pocket cash payments at 27.51% of total healthcare spending; hospital revenue from insurance nearly 60%; total health expenditure at 9.09 trillion yuan; 38 new medications added to insurance directory.

2025：: Revenue grew by 95.97 billion yuan (2.7% increase); expenditure expanded by 0.8% (24.53 billion yuan); surplus at 586.37 billion yuan (increase of 71.4 billion yuan); worker-to-retiree ratio dropped to 2.6; life expectancy projected at 79.25 years; total enrollment recovered to 1.331 billion (increase of 4.06 million people); 50 new medications added to insurance directory (projected).

AI generated, for reference only