China will implement a nationwide policy to virtually eliminate personal expenses for childbirth starting next year, as the country grapples with its declining birth rate.
According to Xinhua News Agency and other Chinese state media on Sunday, the Chinese government announced at the National Medical Insurance Work Conference held the previous day that it would reasonably increase coverage for prenatal examination costs and essentially eliminate out-of-pocket payments for childbirth within the policy scope starting next year. The move signals a shift toward a system where the state assumes responsibility for childbirth-related costs, subject to the medical insurance fund's capacity.
Currently, seven provinces in China including Jilin, Jiangsu and Shandong fully cover hospitalization and delivery medical expenses within their policy scope. The Chinese government plans to expand this free childbirth policy nationwide.
Zhang Ke, director of China's National Healthcare Security Administration, stated, "The goal is to eliminate out-of-pocket costs for hospitalization and delivery expenses covered by medical insurance, from the moment a pregnant woman is admitted to the hospital until she is discharged with her baby." He explained that the aim is to minimize personal burden throughout the entire process from prenatal examinations to delivery and discharge.
Chinese authorities also plan to significantly expand maternity insurance coverage. The plan includes extending coverage to migrant workers from rural areas, flexible workers, and new forms of workers outside traditional employment arrangements. This is designed to reduce childbirth medical expenses for groups previously left in coverage gaps.
Additionally, the government will establish a basic service package including prenatal examinations and include labor pain relief programs in coverage. It also announced plans to improve medical insurance payment management policies for assisted reproductive technology and revise the system to ensure maternity subsidies are delivered directly to insured individuals.
Behind China's strengthened childbirth support policies lies a sharp decline in birth rates. China is seeing a growing trend of avoiding marriage and childbirth amid slowing economic growth, high childcare and education costs, and youth unemployment challenges.
China's annual births have remained below 10 million for three consecutive years from 2022 through last year. The birth rate over the past three years has fallen short of even half of the 2.1 replacement level needed to maintain population. The total population has also declined for three consecutive years. As a result, China has ceded its position as the world's most populous country to India.
Japan is also pursuing free childbirth policies alongside China. As population decline due to low birth rates and aging becomes reality, Japan has begun examining plans to completely eliminate personal expenses related to childbirth.
According to NHK and other Japanese media in May this year, Japan's Ministry of Health, Labour and Welfare held an expert meeting and set a policy to develop a specific system design for eliminating out-of-pocket costs for standard childbirth expenses by next year.
Japan currently provides a lump-sum childbirth and childcare allowance of 500,000 yen (approximately 4.7 million won) and applies public health insurance to cesarean sections. Options under discussion include raising the childbirth and childcare allowance or expanding health insurance coverage to normal deliveries to eliminate personal burden.
