深度｜多地推进长护险落地，社保“第六险”加速扩面

Core Viewpoint - The Long-term Care Insurance (LTCI) system in China is transitioning from pilot programs to nationwide implementation, aiming to provide essential care for the disabled population, which has been accelerated in recent years [1][2][5]. Summary by Sections Long-term Care Insurance Overview - LTCI, known as the "sixth social insurance," has covered approximately 188 million people since its pilot launch in 2015, with recent efforts to expand its reach to more families [2][5]. - The system aims to support individuals with long-term disabilities by providing basic living care and medical services [3][4]. Implementation in Changzhou - Changzhou, a city with a significant aging population (29.7% aged 60 and above by 2024), has fully implemented LTCI since 2022, following a pilot in 2019 [4]. - The city employs a "social-commercial cooperation" model for LTCI, enhancing operational efficiency through partnerships with insurance companies [4]. - As of now, around 25,000 disabled individuals in Changzhou benefit from LTCI, with services including home care and financial support for caregiving [3][4]. Nationwide Expansion - Since 2016, LTCI has been piloted in 15 cities, expanding to 49 cities by 2020, with nearly 1.88 billion participants and 1.4625 million receiving benefits by the end of 2024 [5][6]. - Recent government policies have emphasized the need for a standardized and accelerated establishment of LTCI across the country [6]. Funding Mechanism - The LTCI fund is projected to have a total income of 24.415 billion yuan and expenditures of 13.108 billion yuan in 2024, indicating a stable financial operation [7]. - Funding sources include personal contributions, medical insurance allocations, fiscal subsidies, and employer contributions, with a shift towards a more diversified funding model anticipated [7]. Coverage and Inclusivity - Current coverage primarily includes urban employees and residents under basic medical insurance, with plans to extend benefits to retirees, flexible workers, and unemployed residents [8]. - The LTCI system is designed to be independent and standardized, ensuring equitable access to benefits for all citizens [8]. Challenges and Future Directions - The LTCI system faces challenges related to regional disparities and the "last mile" issue, particularly for disabled individuals who relocate [9][10]. - Efforts are underway to establish inter-provincial service recognition and direct settlement mechanisms to address these challenges [9]. - The involvement of commercial insurance is seen as crucial for enhancing risk management and service integration within the LTCI framework [11].