China: Healthcare Security Law Third Reading Adds Aid and LTC

On August 25, 2026, the Standing Committee of the National People's Congress (NPCSC) opened the third reading of the draft Healthcare Security Law (医疗保障法) at the 24th session of the 14th NPCSC, according to the NPC legislation page published on August 27, 2026. The third-reading text adds statutory subsidies for vulnerable groups joining urban-rural resident basic medical insurance, writes a national long-term care insurance system into the law, and hardens rules on flexible-employment enrolment and cross-provincial medical-expense settlement.

This is the final planned reading before expected adoption. The bill, drafted by the National Healthcare Security Administration and submitted by the State Council, completed first review in October 2024 and second review on April 27 to 30, 2026, with public consultation through May 29, 2026. It has not yet been adopted: a vote, a Presidential Order (主席令), and a fixed effective date must still follow. Until then, China's basic medical-insurance regime continues to rest on administrative rules and departmental measures rather than a dedicated NPCSC statute.

What did the third reading add to the draft?

Four textual moves define the third reading. First, the draft now states that exceptionally impoverished persons, members of households receiving the minimum subsistence allowance, and eligible poverty-prevention targets who join urban-rural resident basic medical insurance shall receive subsidies covering their personal contribution portion under national rules. Second, it provides that the State establishes and improves a long-term care insurance system, with financing, benefits, fund use and supervision to be set by the State Council healthcare-security authority together with relevant departments, by reference to the law's basic medical-insurance provisions. Third, it directs that same authority to formulate, with other departments, specific measures for flexible-employment workers joining employee basic medical insurance. Fourth, it refines cross-provincial (异地就医) settlement: for insured persons treated away from their place of insurance, the portion payable by the medical-security fund at designated medical institutions must be reviewed and then settled and disbursed in full and on time by the healthcare-security agency.

The third-reading text also strengthens coordination between employee basic medical insurance and urban-rural resident basic medical insurance toward fairness and unity, and tightens penalty provisions for responsible persons at designated medical institutions to align with related statutes.

Who is exposed, and what changes for employers?

HR, payroll and benefits leads at companies operating in mainland China are the first audience. Employer contributions to employee basic medical insurance remain a core statutory cost; once the law is adopted, contribution bases, enrolment paths for flexible and platform workers, and coordination with resident cover will sit on a statute rather than a patchwork of notices. Healthcare-security administrators and designated medical institutions face new statutory duties on fund settlement speed, long-term care insurance build-out, and personal liability for responsible staff. Employers that enrol large numbers of flexible or project-based staff should map current contribution practice against the forthcoming State Council measures on flexible-employment participation in employee basic medical insurance, because those measures will implement the third-reading mandate.

What does the vulnerable-group subsidy clause change in practice?

The novelty is the elevation of contribution subsidies for named vulnerable cohorts into the apex medical-security statute. Until adoption, such support rests on policy instruments and local practice. After promulgation, personal-contribution subsidies for exceptionally impoverished persons, minimum-subsistence households and eligible poverty-prevention targets become a legal baseline for urban-rural resident basic medical insurance. Employers do not pay those resident contributions, but group companies with social-responsibility or poverty-alleviation programmes, and any entity that administers resident enrolment for dependents or rural workers, will need to align internal benefit processes with the national subsidy rules once issued.

What is the path from third reading to entry into force?

Under the PRC legislative sequence, the Healthcare Security Law still requires adoption by the NPCSC, promulgation by Presidential Order, publication, and then entry into force after any vacatio legis set in the Order. The August 25 to 28, 2026 session was the expected window for this third reading; final passage is anticipated by end-2026. No effective date is fixed yet.

Continuous, per-jurisdiction real-time monitoring surfaces this kind of committee-stage statutory change the moment the NPC publishes it.

Take advantage of this real-time watch

For compliance and benefits leads, the near-term checklist is concrete. Confirm whether your China payroll enrols flexible or platform workers who may shift onto employee basic medical insurance under the forthcoming State Council measures. Flag the long-term care insurance build-out for finance and HR budgeting once implementing rules appear. Brief legal, HR and healthcare-security contacts on the vulnerable-group subsidy baseline and the cross-provincial settlement timing duty. Obsidian will track the Healthcare Security Law from this third reading through Presidential Order and effective date.