China’s Gig Worker Healthcare Enrollment Slows Under Weight of High Premiums

China is struggling to bring its massive gig-economy workforce into the national healthcare system, as enrollment growth among flexible workers slows under the weight of prohibitive premium costs.

While China’s overall basic medical insurance coverage has stabilized above 95%, the flexible employment sector remains a critical gap in the country’s social safety net. Nearly 69.82 million flexible workers and other individuals enrolled in the national employee basic medical insurance program in 2025, an increase of more than 20 million from 2021.