China is moving toward a nationwide long-term care insurance system as the country faces a rapidly aging population and a growing number of people who may eventually need help with basic daily activities.
The government has set a target of having the system essentially cover the country by the end of 2028, marking a major shift from years of regional pilot programs toward a more unified national framework.
The issue is becoming increasingly urgent. By the end of 2025, China had about 323.38 million people aged 60 and above, representing roughly 23 percent of the population. That number is projected to surpass 400 million around 2035.
From pilot programs to a nationwide system
China began experimenting with long-term care insurance in 2016. Over the following decade, the program expanded to hundreds of millions of participants and provided benefits to people with significant functional impairments.
Official figures reported in March showed that nearly 310 million people had enrolled in pilot long-term care insurance programs, while more than 3.3 million people with disabilities had benefited.
The new nationwide approach is designed to provide basic living-care and related medical-care support to people who have lost some or all of their ability to care for themselves.
Services can include assistance with eating, bathing and using the toilet, as well as certain medical and rehabilitation services.
But the transition will not be simple.
One of the biggest challenges: uneven development
China’s existing long-term care system has developed differently from one region to another.
That can create problems for families who move across municipal or regional boundaries.
The South China Morning Post highlighted the experience of an elderly Shanghai resident whose access to subsidized home-care services was affected after his family moved across the administrative boundary into Suzhou. Even though both areas had long-term care insurance programs, their financing and payment arrangements were separate.
A nationwide system is intended to reduce this kind of fragmentation.
However, China still has major differences in economic development, healthcare resources and eldercare capacity between regions.
That means establishing the insurance framework nationwide does not automatically guarantee that every elderly person will have the same access to quality care.
Who will pay for it?
Funding is another major question.
Under the framework announced in March, long-term care insurance is expected to rely on multiple sources, including employers, individuals, government funding and other social resources.
The government has also outlined a target contribution rate of around 0.3 percent, although specific arrangements can vary depending on the category of participant and local implementation.
Initially, the system will focus primarily on people with severe functional impairments. Coverage could gradually expand as the system develops and funding capacity improves.
For eligible workers, the proposed framework indicates that the insurance fund could cover around 70 percent of qualifying long-term care service expenses, while the proportion for unemployed urban and rural residents would be around 50 percent, subject to the applicable rules and local implementation.
The numbers behind the pressure
China’s aging population is not simply about having more senior citizens.
It also means a potentially larger population requiring sustained assistance.
Xinhua reported that around 45 million older people in China are affected by physical or cognitive impairments, while the number of seniors with functional impairments is expected to rise further in the coming years.
That creates a difficult challenge for families.
Traditionally, much of elderly care in China has been handled by relatives. But smaller households, changing family structures and population aging are making that model increasingly difficult to sustain.
Long-term care insurance is therefore being positioned not simply as another insurance product, but as part of a broader restructuring of China’s social-security system.
China is also putting long-term care into law
The push gained another major boost in August.
China’s National People’s Congress adopted a new Healthcare Security Law on August 28, 2026, which includes provisions requiring the establishment and improvement of a long-term care insurance system.
The law is scheduled to take effect on January 1, 2027.
That gives the long-term care program a stronger legal foundation as authorities work toward the 2028 nationwide coverage target.
But the biggest question remains
Building the insurance system is only one part of the problem.
China will also need enough trained caregivers, assessment professionals, nursing facilities and home-care services to meet demand.
Xinhua reported that the number of designated long-term care providers has grown substantially since the pilot program began, reaching about 12,000, while the country continues to develop its professional caregiving workforce.
Technology is also expected to play a growing role, including home-monitoring systems, assistive devices and potentially smart-care technologies.
For China, the challenge now is no longer simply recognizing that its population is aging.
The bigger test will be whether the country can build a long-term care system that is affordable, accessible and consistent enough to support millions of families—before the aging wave becomes even larger.
WWC ONE MEDIA J.M.D
Leave a Reply