China News Service, Beijing, November 5 (Reporter Zhao Fangyuan) On November 5, at the media interpretation meeting of the Medical Insurance Wallet 2.0 held by the National Medical Insurance Administration, Zhang Chenguang, deputy director of the Department of Finance and Law of the National Medical Insurance Administration, introduced that the overall situation of my country's basic medical insurance participation in 2026 is stable and rising. As of the end of September 2026, the number of people covered by basic medical insurance was 1.328 billion, including 391 million people covered by employee medical insurance and 937 million people covered by resident medical insurance.
Zhang Chenguang introduced that the number of insured persons as of the end of September 2026 has exceeded the full-year level of 2024, and the number of insured persons by the end of October has reached the full-year level of 2025. It is a foregone conclusion that the number of insured persons for the whole year will exceed last year, and positive growth will be achieved for two consecutive years.
Regarding the reasons for the increase in the number of insured persons, Zhang Chenguang believes that there are at least five aspects: First, the personal payment standard remains unchanged. The personal payment standard for resident medical insurance from 2025 to 2027 is 400 yuan, which has not increased for two consecutive years and has remained unchanged for three years. At the same time, the financial subsidy has increased from 670 yuan to 724 yuan, which effectively reduces the insurance payment burden of the masses. The second is to launch a long-term mechanism for insurance participation. Third, services are continuously optimized. The fourth is to enhance people’s awareness of insurance participation. Fifth, people actually enjoy the benefits of medical insurance reimbursement when seeking medical treatment.
In response to the statement that "the number of residents insured for medical insurance has dropped for the seventh consecutive time, by 83 million" that has attracted attention from online public opinion, Zhang Chenguang explained that the decline in the number of insured persons is caused by many reasons.
The first is to manage duplicate insurance participation. When the National Medical Insurance Administration was established, a national unified medical insurance information platform had not yet been established, the integration of urban and rural residents had not yet been completed, and there were some duplication of insurance coverage in various places. Since 2019, the National Medical Insurance Administration has begun to eliminate duplicate enrollment. According to statistics, from 2019 to 2024, more than 25 million people nationwide have been eliminated from duplicate enrollment and invalid data in resident medical insurance.
The second is to switch residents to employee medical insurance. From 2019 to 2025, the number of people covered by employee medical insurance will increase from 329 million to 389 million, an increase of 60 million, and the proportion of all insured people will increase from 24.3% to 29.2%. The insurance structure continues to be optimized. Most of the increase in the number of employees was transferred from residents’ medical insurance.
The third is a net decrease in the permanent population. After the national population reached its peak in 2021, it had decreased by a total of 7.71 million by the end of 2025.
"Starting from 2025, the decline in resident medical insurance is consistent with the changing trend of my country's total population and is consistent with the optimization of the insurance participation structure. It is a reasonable and normal decline." Zhang Chenguang said.
Zhang Chenguang also mentioned that in 2025, the national employee medical insurance personal account will be used to pay 34.2578 million personal payments for close relatives to participate in the province's urban and rural residents' medical insurance, with a payment amount of 14.227 billion yuan. Personal accounts in the province have demonstrated effectiveness.
At the same time, Zhang Chenguang disclosed that the number of people enjoying outpatient reimbursement benefits from resident medical insurance will reach 493 million in 2025, exceeding 50% of the total number of residents insured by resident medical insurance; the number of people enjoying reimbursement benefits from resident medical insurance in the past five years has exceeded 830 million, that is, more than 80% of residents insured by resident medical insurance have enjoyed reimbursement benefits in the past five years.
Regarding some comments on the Internet such as "medical insurance is too expensive and useless", "young people do not need to be insured if they are not sick", "I have not been insured for many years", Zhang Chenguang said that this reflects the general public's concern and expectations for medical insurance. However, the vast majority of people across the country are insured. It is a fact that the number of insured people has been growing for two consecutive years. The data on benefits are also real. Behind this is the stability and peace of mind of thousands of households who are "covered and treated".
