Solving the Long-Term Care Challenges for Disabled Elderly: China Accelerates the Establishment of Long-Term Care Insurance System

According to Xinhua News Agency, the General Office of the CPC Central Committee and the State Council issued the “Opinions on Accelerating the Establishment of a Long-term Care Insurance System” (hereinafter referred to as the “Opinions”) on March 25. The document provides comprehensive arrangements in areas such as establishing a policy system that coordinates urban and rural areas, creating a stable and sustainable funding mechanism, implementing fair and moderate benefit guarantees, and establishing a scientific and standardized management and operation system.

The “Opinions” mention that within about three years, the institutional arrangements for urban and rural coordination will be basically established, a shared responsibility funding mechanism and a fair and moderate benefit guarantee system will be gradually improved, and a scientific and standardized management and operation system will take shape. The long-term care insurance system suited to China’s basic national conditions will be fundamentally established.

Regarding the policy system for urban and rural coordination, the “Opinions” state that the institutional arrangements will be unified. Employers (including enterprises, public institutions, government agencies, and social organizations), as well as employees, retirees, flexible employment workers, and unemployed urban and rural residents, will participate in long-term care insurance based on the principle of territorial management. The long-term care insurance fund (hereinafter referred to as the “fund”) will be managed with unified accounts, and funds will be pooled for use.

In establishing a stable and sustainable funding mechanism, the “Opinions” specifically emphasize setting reasonable contribution standards and sharing mechanisms. The long-term care insurance premium rate will be controlled at around 0.3%. The contribution rate for employees will be shared equally by employers and individuals, with the employer’s contribution base based on total wages, and the individual’s contribution base based on their own income. Both employers and employees will contribute jointly. Retirees will pay the same rate as employed workers, with the contribution base linked to pension levels, and contributions paid by individuals only; employers will no longer contribute.

In implementing fair and moderate benefit guarantees, the “Opinions” mention that the eligible beneficiaries will be reasonably determined. Those who have paid premiums according to regulations and experience long-term disability (generally over six months), and have been approved through assessment, can receive related benefits. During the initial stage of the long-term care insurance system, benefits will primarily support severely disabled individuals.

Additionally, the “Opinions” specify that benefit standards should be reasonably set. The national level will define the baseline benefit standards for long-term care insurance, with localities allowed to make moderate adjustments based on actual conditions. There will be no deductible standard for benefits. For eligible long-term care services, if insured as unemployed urban and rural residents, the fund will cover about 50%; if insured as employees, the coverage will be about 70%, with retirees enjoying the same benefits as employed workers; flexible employment personnel will receive benefits according to their chosen insurance policy type.

Regarding the establishment of a scientific and standardized management and operation system, the “Opinions” call for improving the nationwide standard for disability level assessment, promoting mutual recognition of assessment results across the country, and encouraging relevant departments to use them as needed. They also explore establishing standards for long-term care needs assessment and service planning. Strengthening fund management and supervision is emphasized, with the fund being included in the social security fund’s fiscal account, managed separately, with dedicated accounts and funds.

Currently, China has over 320 million people aged 60 and above, including approximately 35 million with disabilities. Ensuring their basic living care and medical needs, easing the burden on families, and gaining widespread social attention.

At the “2025 National Long-term Care Insurance High-Quality Development Conference” held at the end of 2025, Zhang Ke, Secretary of the Party Leadership Group and Director of the National Healthcare Security Administration, publicly stated that during the 14th Five-Year Plan period, the long-term care insurance system will shift from pilot programs to full implementation.

The Government Work Report for this year reviewed that by 2025, the long-term care insurance system will cover 300 million people; and in outlining tasks for 2026, it explicitly states the promotion of the long-term care insurance system.

The “14th Five-Year Plan Outline for National Economic and Social Development of the People’s Republic of China (Draft)” reaffirms that during the “14th Five-Year Plan” period, long-term care insurance will be promoted, the professionalization of elderly care service personnel will be advanced, and the overall supervision and quality of elderly care services will be improved.

Interface News found that several provinces have already issued documents to promote the implementation of the long-term care insurance system.

On March 17, the Hebei Provincial Medical Security Bureau issued a notice clarifying matters related to social forces participating in the operation of Hebei’s “Sixth Insurance” long-term care insurance. The notice states that the long-term care insurance system will be fully implemented across the province by 2026, with each coordination area conducting open bidding or selection based on actual conditions to gradually introduce social entities to manage the services.

Recently, the Sichuan Provincial Government Office issued the “Implementation Plan for Establishing a Long-term Care Insurance System in Sichuan Province.” According to the plan, the system will be launched in eligible coordination areas this year; by 2027, the entire province will fully implement the long-term care insurance system, ensuring orderly integration with social welfare and assistance policies, and promoting the development of commercial care insurance and related industries. By 2028, a multi-layered long-term care security system featuring shared responsibility, fairness, moderation, and scientific standards will be fundamentally established.

(Source: Interface News)