China's National Healthcare Security Administration (NHSA) has released its 15th Five-Year Plan for universal healthcare security on Wednesday, marking a critical period for further improving the country's medical security system.

Drawing on current conditions, public demand for healthcare services and China's broader reform agenda, the plan sets out key priorities for 2026-2030, including responses to population ageing, stronger support for families and fertility, and the high-quality development of innovative medicines.

Expanding long-term care

Under the plan, China will work to establish a nationwide long-term care insurance system, shifting medical security from disease treatment to long-term care and support.

Healthy aging is a key component of the Healthy China initiative. To ease the burden on families caring for elderly people with disabilities, China began piloting long-term care insurance in 2016. After nearly a decade of exploration, the system was expanded nationwide this year, with about 320 million people now covered.

The expansion has also created demand for a growing professional workforce. Long-term care specialists have emerged as a new occupation, and China held its first vocational skills grading examination for the profession in April. So far, more than 50,000 practitioners have obtained relevant certificates.

China is home to around 35 million elderly people with disabilities, while the shortage of professional caregivers is estimated at more than 10 million. As long-term care insurance expands, the sector is attracting more young practitioners.

Making maternity support more accessible

The 15th Five-Year Plan also places greater emphasis on improving maternity-related benefits and services.

One of its development targets for 2026-2030 is to enable maternity allowances to be paid directly to individuals. The move is intended to streamline the application and disbursement process and ease the financial burden on families.

China will also advance direct cross-provincial settlement of maternity-related medical expenses and further improve settlement services for people seeking medical treatment outside their home regions. Digital and information-technology systems will also be upgraded to support these efforts.

Creating more room for pharmaceutical innovation

The plan also sets out six key areas to support pharmaceutical innovation: access to healthcare data, unified management of the national drug catalog, independent pricing mechanisms, healthcare payment reform, supplementary commercial health insurance, and platforms to help Chinese medicines expand into overseas markets.

Together, these measures aim to make better use of medical insurance data to inform research and development, improve market access through unified drug catalog management, and strengthen value-based pricing. Reforms to healthcare payment mechanisms are expected to create more room for innovative products, while commercial health insurance can provide an additional source of funding alongside basic medical insurance.

China will also support qualified innovative medicines in being added to the national medical insurance catalog through established procedures, while further optimizing the innovative drug catalog for commercial health insurance. At the same time, platforms will be developed to help Chinese pharmaceutical companies explore international markets.

The NHSA has issued 40 batches of guidelines for establishing medical service pricing items so far, adding around 180 new items covering technologies and products such as surgical robots, brain-computer interfaces and artificial hearts.

Toward a more inclusive healthcare system

Taken together, the 15th Five-Year Plan for universal healthcare security addresses some of the country's most pressing healthcare challenges, from population ageing and fertility support to the development of innovative medicines.

The measures point toward a more comprehensive, multi-layered healthcare security system designed to benefit the broader population. By placing people's well-being at the center while creating greater space for innovation, the plan is expected to support both people-centered social development and the high-quality development of China's healthcare sector.