为减轻分娩医疗费用负担，国家医保局提出“力争全国基本实现政策范围内分娩个人无自付”的改革目标。无自付政策可以减轻分娩医疗费用负担，同时也会增加医保基金支出。本文基于某医院2023—2025年分娩个体数据，设置了四种改革政策情景，从静态和动态视角模拟测算了无自付政策对医保基金支出的影响。模拟测算发现，无自付政策将显著增加用于分娩报销的医保基金支出，但对整体医保基金支出的影响有限;无自付政策对居民分娩医保基金支出的影响大于职工医保;动态视角下无自付政策对医保基金支出的影响更大;通过管理剖宫产率和分娩医疗费用，可有效降低无自付政策对医保基金支出的影响。研究表明，无自付政策总体可行，但各地需要加强医保基金支出测算，循序渐进推进无自付政策，并同步加强分娩医疗费用管理。

To reduce the burden of medical expenses for childbirth, the National Healthcare Security Administration has proposed a reform goal of "striving to achieve a situation where individuals have no out-of-pocket expenses for childbirth within the policy coverage range across the country". The zero out-of-pocket policy can reduce the burden of medical expenses for childbirth, but it will also increase the expenditure of the medical insurance fund. Based on the individual data of childbirth at a hospital from 2023 to 2025, this paper sets up four reform policy scenarios, and simulates and calculates the impact of the zero out-of-pocket policy on the medical insurance fund expenditure from both static and dynamic perspectives. The simulation calculation show that the zero out-of-pocket policy will significantly increase the medical insurance fund expenditure for childbirth reimbursement, but its impact on the overall medical insurance fund expenditure is limited. The zero out-of-pocket policy has a greater impact on the medical insurance fund expenditure for residents' childbirth than for employees' childbirth. From a dynamic perspective, the zero out-of-pocket policy has a greater impact on the medical insurance fund expenditure. By controlling the rate of cesarean sections and the medical expenses for childbirth, the impact of the zero out-of-pocket policy on the medical insurance fund expenditure can be effectively reduced. The research indicates that the zero out-of-pocket policy is generally feasible, but all regions need to strengthen the calculation of medical insurance fund expenditure, gradually promote the zero out-of-pocket policy, and simultaneously strengthen the management of medical expenses for childbirth.