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Millions drop out of China’s state health insurance system

Rising premiums drive cash-strapped families to cancel coverage, fuelling fears about economic slowdown

China’s state health insurance system has lost tens of millions of subscribers, as higher costs have put one of the world’s largest healthcare schemes out of reach for many people already struggling in a post-pandemic economic downturn.

Enrolment across China’s state-subsidised health insurance system, which covers more than 1.3bn policyholders across multiple programmes, fell by an unprecedented 19mn people in 2022, according to official data.

Enrolment could fall further this year, officials and analysts have warned. Of the eight provinces that have reported enrolment data for the first nine months of 2023, seven showed a drop from a year earlier.

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