China’s population has contracted for three consecutive years, and projections show 400 million people will be over 60 by 2035—a figure approaching the combined populations of the United States and Italy—driving Beijing to commit an estimated 180 billion yuan this year to policies aimed at reversing the decline.
The government outlined plans Thursday to construct what it called a “childbirth-friendly society” over the next five years, pairing financial incentives with expanded social services as authorities confront a demographic shift that threatens consumption patterns and pension stability.
The measures include full reimbursement of pregnancy-related medical costs, subsidized childcare programs and education reforms designed to ease the logistical and financial burden on families.
Starting in 2026, women will pay nothing out of pocket for medical expenses during pregnancy, including in vitro fertilization treatments, under the national insurance system.
Reproductive health services and birth defect prevention programs will be strengthened as part of the effort to encourage what the government described as “positive attitudes towards marriage and childbearing.”
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Childcare subsidies will continue, with trials planned for expanded subsidized services. Housing support for families with children will also grow, though specifics on eligibility and funding levels were not detailed in Thursday’s announcement.
The 180 billion yuan budgeted for 2026 covers national child subsidies, pregnancy medical coverage and expanded education and childcare infrastructure. Whether that investment will be enough to shift behavior in a society where rising costs, job insecurity and changing social norms have driven birth rates to historic lows remains uncertain.
Education spending is mandated to exceed 4 percent of GDP, with reforms targeting free preschool education and increased availability of senior secondary school places. Authorities framed the initiatives as efforts to improve long-term human capital development while relieving pressure on households weighing whether to have children.
China’s birthrate began falling sharply after the one-child policy was abandoned, defying expectations that relaxing restrictions would trigger a baby boom. Young adults have cited housing costs, career demands and the expense of raising children as reasons for delaying or forgoing parenthood entirely.
The aging trend compounds the challenge. The government has raised retirement ages to 63 for men and 58 for women in an attempt to address workforce shortages and ease strain on pension systems. Even with those adjustments, the ratio of workers to retirees continues to worsen, threatening the sustainability of social security programs.
Officials said they would develop what they termed the “silver economy,” expanding elderly care services particularly in rural areas where infrastructure lags behind urban centers.
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Pension, wellness and support programs for those over 60 will be refined, though the report provided limited detail on how those services would be funded or delivered at scale.
By the time today’s working-age adults retire, there may not be enough younger workers to support them through traditional pension models.
That has prompted discussions about immigration, automation and fundamental reforms to how China structures its social safety net.
The government’s broader strategy seeks to sustain economic growth amid demographic headwinds by improving employment, healthcare and income for families. Whether financial incentives alone can overcome cultural and economic factors depressing birth rates is unclear. Similar programs in Japan, South Korea and parts of Europe have had limited success reversing fertility declines once they take hold.
Beijing’s emphasis on fostering “positive attitudes” toward childbearing suggests authorities recognize that changing behavior requires more than subsidies. But the tools available to reshape social norms without coercion are limited, and the window for avoiding severe demographic imbalances may be narrowing. The measures announced Thursday represent the latest iteration of policies that have evolved as the scale of the problem has become clearer. The one-child policy was replaced by a two-child policy in 2015, then a three-child policy in 2021, each time with predictions that births would rebound. They did not.
Now, with the population shrinking and the elderly cohort expanding rapidly, the government is betting that comprehensive support—covering everything from IVF to preschool—will succeed where earlier, narrower interventions failed. The 180 billion yuan price tag indicates officials understand the stakes, even if the outcome remains uncertain.