China has now entered a critical stage of promoting high-quality full employment and fostering high-quality population development. Maternity insurance serves as one of the important institutional arrangements bridging employment and childbirth. The 15th Five-Year Plan proposes to "expand the coverage of the maternity insurance system," making the achievement of universal maternity coverage a core issue in the construction of the childbirth support policy system. Focusing on the policy goal of expanding maternity insurance coverage during the 15th Five-Year Plan period, this paper systematically reviews the evolution and current policy framework of China's maternity insurance system, analyzes its coverage status and gaps, and explores the main obstacles and challenges to coverage expansion. From the perspective of institutional attributes, it examines the risks of adverse selection and the potential for fund fraud. Taking into account the changing trends in population structure and employment patterns, this paper proposes reform pathways for expanding maternity insurance coverage: first, optimizing the existing social insurance system; and second, establishing a universal and inclusive maternity coverage system for all citizens. It also provides estimates of the financing requirements and fiscal burdens associated with these two reform pathways.
Key words
maternity insurance /
coverage gaps /
expansion challenges /
improvement pathways
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