BEIJING, Dec. 15 (Xinhua) -- China has unveiled a plan to make childbirth essentially free under the national medical insurance system by 2026, as authorities seek to ease family financial burdens to foster a birth-friendly society.
The plan, announced at a recent national healthcare security conference, aims to ensure that the basic costs of childbirth are fully covered by insurance programs nationwide, leaving families with no out-of-pocket expenses for standard delivery services within policy limits.
Seven provincial-level regions, including Shandong, one of China's most populous provinces, already offer full coverage of in-hospital childbirth medical expenses within policy scopes.
Zhao Chunmei, vice president of a women and children's hospital in Jinan, Shandong, said that at her hospital, women covered by employee maternity insurance typically pay less than 1,000 yuan (about 141.53 U.S. dollars) out of pocket for a standard hospital delivery.
"The costs have dropped sharply from previous levels, significantly easing the financial burden on families," Zhao said.
The national free-childbirth policy applies only to standard medical services. Expenses incurred at premium-priced hospitals, or for drugs and materials not included in the basic insurance catalog, will not be reimbursed.
The National Healthcare Security Administration said it is also planning to expand maternity insurance coverage to include flexible workers, migrant workers and people in new forms of employment, among other measures aimed at encouraging childbirth.
Officials said coverage for prenatal checkups will also be expanded, depending on the sustainability of the national medical insurance fund.
China's total fertility rate has remained low for years, and since 2022, its population has entered a period of decline. China's population stands at roughly 1.4 billion.
This year's Central Economic Work Conference included fertility policy on its agenda, noting the efforts to "stabilize the number of newborns."
In recent years, a series of measures have been afoot as the government increasingly focuses on population aging and declining fertility, a challenge faced by many nations.
This July, China introduced a nationwide childcare subsidy program, which will provide families with an annual subsidy of 3,600 yuan for each child under the age of three starting from Jan. 1, 2025. The program is expected to benefit more than 20 million families every year.
"This marks China's first direct cash subsidies for all families with children, sending a clear message that raising children is a shared responsibility of the country, society and families," said Du Min, a researcher at the China Population and Development Research Center.
The Chinese government has begun phasing in free preschool education, waiving care and education fees for children in their final year of kindergarten starting from the autumn semester this year. It is expected to save household spending by about 20 billion yuan in this autumn semester alone.
Notably, assisted reproductive services are now covered by medical insurance across 31 provincial-level regions and in the Xinjiang Production and Construction Corps, and painless delivery services are also covered in certain regions.
The rollout of such policies has also sparked widespread public attention. Many netizens have raised their concerns, including childcare, parenting burdens and work-life balance, in addition to financial support.
A Weibo user expressed hope that more supportive policies would follow to gradually address the wide range of challenges involved in having and raising children.
Economist Luo Zhiheng highlighted the growing emphasis among Chinese policymakers on investing in human capital, focusing on initiatives that develop people's capabilities and unlock their potential at all stages of life, including childcare, elderly care, health, education and skills training.
"Investment should be linked to population mobility, demographic structure and measures to raise the fertility rate," Luo said. "The government should increase funding to further lower the costs of childbirth, education and child-rearing, thereby boosting people's willingness to have children."
Currently, the country has 126,000 childcare service institutions, providing a total of 6.657 million childcare spots. The number of publicly accessible spots has increased noticeably, reaching 4.73 spots per 1,000 people.
In Meishan, Sichuan Province, a local childcare center is offering health checkups and developmental screenings for children. The center, which has 140 places, combines pediatric healthcare with childcare services, providing full-day, half-day and hourly care for children aged 0 to 3.
These policies are expected to continue into next year and beyond. According to recommendations for China's 15th Five-Year Plan (2026-2030) for national economic and social development, the country aims to encourage positive views on marriage and childbearing, refine the policies and incentives for boosting birth rates, and effectively bring down the costs of childbirth, parenting, and education through childcare subsidies and personal income tax credits. ■
