Birth policy changes and the sustainability of social medical insurance funds: implications for green growth

Given China’s aging population and the introduction of the three-child policy, there are implications for the future population covered by basic medical insurance funds in urban and rural China. Based on the concept of sustainable development, this study uses the cohort-component projection method to calculate the population covered by basic medical insurance funds and the aging of the insured population in China from 2020 to 2050 based on several assumed scenarios of the total fertility rate. Our results show that, first, the three-child policy can increase China’s total fertility rate but cannot alleviate the aging problem of the population covered by medical insurance. Second, the three-child policy has a delayed effect on alleviating the aging issue of the insured population. Third, the aging problem of urban and rural residents covered by insurance is more severe than that of urban employees covered by insurance. Finally, policy recommendations are proposed based on this research.