A new legal provision is set to encourage self-employed individuals without hired staff, part-time workers not covered by employer-based employee basic medical insurance, and other flexible workers to participate in the employee basic medical insurance system. The specific implementation measures will be formulated by the State Council's medical security administrative department in coordination with relevant government bodies, as stipulated in the Medical Security Law of the People's Republic of China, which was approved on August 28, 2026, at the 24th session of the Standing Committee of the 14th National People's Congress.

China's basic medical insurance framework is divided into two categories: employee medical insurance and resident medical insurance, with the latter referring to basic medical insurance for urban and rural residents. Data from the 2025 National Medical Security Development Statistical Bulletin, released by the National Healthcare Security Administration in July 2026, reveals that as of the end of 2025, the total number of basic medical insurance participants nationwide reached 1.3306939 billion, maintaining a coverage rate of 95%. Among these, 388.5612 million people were enrolled in employee medical insurance, while 942.1327 million participated in resident medical insurance. Notably, 69.8218 million flexible workers and other individuals had enrolled in employee medical insurance.

Estimates suggest that the country's flexible workforce now exceeds 200 million people, indicating that a significant portion of this group has either opted for resident medical insurance or remains uninsured. Yu Baorong, a professor at the Insurance School of the University of International Business and Economics, explained that in practice, flexible workers constitute a vast and diverse demographic with the choice to join either insurance type.

Their decision largely hinges on a cost-benefit analysis, weighing contribution burdens against the level of benefits provided, Yu noted. The law's use of the term "encourage" signals the state's endorsement of flexible workers prioritizing employee medical insurance, reflecting a policy push to expand coverage among this growing segment of the labor force.