The NHSA denied there has been a wave of cancellations in the voluntary urban and rural residents’ scheme, which covers roughly just over 70 per cent of China’s 1.4 billion population and is one of the two schemes under the state health insurance system.
About 25 million dropped out of the scheme in 2022, according to figures released late last year, but the NHSA called the fall a “slight fluctuation”.
The administration said the fluctuation was mainly because cross-provincial reimbursement has been allowed since 2022, leading many who used to take out plans in their hometown and their places of work to cut to just one.
Before the reform in 2022, policyholders had been only allowed to claim expenses in one province, which prompted many migrant workers to join multiple schemes.
In short, they find not enough value for the money
The NHSA also noted that an increasing number of new joiners to the labour market, previously covered by the urban and rural scheme, were turning to the other scheme – the urban employees’ programme which is mandatory for formally-employed workers and has better financial coverage and benefits.
However, official figures show that the overall participation in the two programmes, which covered over 96 per cent of the population between 2019 and 2021, fell by over 1 percentage point in 2022, implying a much greater number cancelling the urban and rural scheme than joining the urban employees’ programme.
Professor He Wenjiong, deputy director of the China Association of Social Security, said factors listed by the NHSA were not the main reasons for the falling number of participants.
“The major reason is that people’s income has remained low, while the premiums have risen, and the rising cost isn’t helping them save more money when seeking medical services,” he said. “In short, they find not enough value for the money.”
As enthusiasm wanes, can China halt exodus from its health insurance scheme?
As enthusiasm wanes, can China halt exodus from its health insurance scheme?
The minimum personal contribution required for the urban and rural residents’ programme has surged by nearly 40 folds in the past two decades, rising from just 10 yuan (US$1.4) a year when it was established in 2003 to 380 yuan (US$52.5) in 2023.
In comparison, the average disposable income of rural residents was over 21,000 yuan last year, which is about eight times of that in 2003.
It also encouraged more young and healthy people to contribute to the programme.
