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Guiding Opinions of the State Council about the Pilot Urban Resident Basic Medical Insurance
(No. 20 [2007] of the State Council)
The people's governments of all provinces, autonomous regions, and municipalities directly under the Central Government, all ministries, commissions and directly subordinate institutions of the State Council:
The CPC Central Committee and the State Council attach great importance to the medical security of the broad mass, and constantly improve the medical security system. In 1998, our country began to establish the basic medical insurance system of urban employees, afterwards, launched the pilot new-type rural cooperative medical system and established the urban and rural medical care system. For the time being, only the non-employed urban residents have not been covered by the medical security system. In order to realize the target of establishing the basic medical security system basically covering all the urban and rural inhabitants, the State Council decided to launch the pilot urban resident basic medical insurance (hereinafter referred to as “pilot work”). All the regions and all the departments shall fully realize the significance of this work, and take it as an important task for fulfilling the scientific concept of development and constructing the socialist harmonious society, attach great importance, plan it as a whole, guide it with rules, and promote it stably.
| | 国务院关于开展城镇居民基本医疗保险试点的指导意见
(国发〔2007〕20号)
各省、自治区、直辖市人民政府，国务院各部委、各直属机构：
党中央、国务院高度重视解决广大人民群众的医疗保障问题，不断完善医疗保障制度。1998年我国开始建立城镇职工基本医疗保险制度，之后又启动了新型农村合作医疗制度试点，建立了城乡医疗救助制度。目前没有医疗保障制度安排的主要是城镇非从业居民。为实现基本建立覆盖城乡全体居民的医疗保障体系的目标，国务院决定，从今年起开展城镇居民基本医疗保险试点（以下简称试点）。各地区各部门要充分认识这项工作的重要性，将其作为落实科学发展观、构建社会主义和谐社会的一项重要任务，高度重视，统筹规划，规范引导，稳步推进。
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I. Targets and Principles
| | 一、目标和原则
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1. Targets of the pilot work: a qualified province may select two or three cities for the pilot work in 2007, the pilot scope will be expanded in 2008, the proportion of pilot cities will reach 80 % or more in 2009, and the pilot work will be comprehensively promoted across the country and all the non-employed urban residents will be gradually covered in 2010. The pilot work will be implemented so as to explore and improve the policy system of urban resident basic medical insurance, form a reasonable capital raising level, a sound management system and a normalized operating mechanism, and gradually establish the urban resident basic medical insurance system dominated by the comprehensive insurance arrangement of serious diseases.
| | （一）试点目标。2007年在有条件的省份选择2至3个城市启动试点，2008年扩大试点，争取2009年试点城市达到80%以上，2010年在全国全面推开，逐步覆盖全体城镇非从业居民。要通过试点，探索和完善城镇居民基本医疗保险的政策体系，形成合理的筹资机制、健全的管理体制和规范的运行机制，逐步建立以大病统筹为主的城镇居民基本医疗保险制度。
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2. Principles of the pilot work: in the implementation of pilot work, it is imperative to start from the low level, set reasonable funding levels and security standards according to the economic development level and the affordability of all sectors, focus on the security of medical needs of urban non-employed residents for serious diseases, and gradually enhance the security level; to adhere to the principle of free will, fully respect the wishes of the mass; clarify the responsibility of the Central Government and the local government, namely, the Central Government will determine basic principles and major policies, and the local government will formulate specific measures and implement the territorial management of participating residents; and to adhere to the principle of comprehensive arrangement and coordination, and realize the link-up among basic policies, standards and management measures, etc. for various medical security systems.
| | （二）试点原则。试点工作要坚持低水平起步，根据经济发展水平和各方面承受能力，合理确定筹资水平和保障标准，重点保障城镇非从业居民的大病医疗需求，逐步提高保障水平；坚持自愿原则，充分尊重群众意愿；明确中央和地方政府的责任，中央确定基本原则和主要政策，地方制订具体办法，对参保居民实行属地管理；坚持统筹协调，做好各类医疗保障制度之间基本政策、标准和管理措施等的衔接。
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II. Insurance Coverage and Capital Raising Level
| | 二、参保范围和筹资水平
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3. Insurance coverage. Primary and secondary school students (including the students of vocational high schools, secondary specialized schools and technical schools), juvenile, children and other non-employed urban residents that are not covered by the basic medical insurance system of urban employees may voluntarily participate in the urban resident basic medical insurance.
| | （三）参保范围。不属于城镇职工基本医疗保险制度覆盖范围的中小学阶段的学生（包括职业高中、中专、技校学生）、少年儿童和其他非从业城镇居民都可自愿参加城镇居民基本医疗保险。
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4. Capital raising level: A pilot city shall, according to its local economic development level, the basic medical consumption needs of adults, minors and other groups of people, and by considering the financial affordability of local residents' families and the state treasury, properly determine the capital raising level; and explore a mechanism of linking the capital raising level, years of payment and the level of treatment together.
| | （四）筹资水平。试点城市应根据当地的经济发展水平以及成年人和未成年人等不同人群的基本医疗消费需求，并考虑当地居民家庭和财政的负担能力，恰当确定筹资水平；探索建立筹资水平、缴费年限和待遇水平相挂钩的机制。
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5. Payments and subsidies. The urban resident basic medical insurance premiums shall be mainly paid by families and be properly supported by governments. Participating residents shall pay basic medical insurance premiums according to legal provisions and enjoy corresponding medical insurance treatments, and a qualified employer may grant subsidies to the insurance premiums of its employees' family members. The state will formulate the tax incentive policy for the said individual payments and the subsidies of employers.
．．．．．． | | （五）缴费和补助。城镇居民基本医疗保险以家庭缴费为主，政府给予适当补助。参保居民按规定缴纳基本医疗保险费，享受相应的医疗保险待遇，有条件的用人单位可以对职工家属参保缴费给予补助。国家对个人缴费和单位补助资金制定税收鼓励政策。
对试点城市的参保居民，政府每年按不低于人均40元给予补助，其中，中央财政从2007年起每年通过专项转移支付，对中西部地区按人均20元给予补助。在此基础上，对属于低保对象的或重度残疾的学生和儿童参保所需的家庭缴费部分，政府原则上每年再按不低于人均10元给予补助，其中，中央财政对中西部地区按人均5元给予补助；对其他低保对象、丧失劳动能力的重度残疾人、低收入家庭60周岁以上的老年人等困难居民参保所需家庭缴费部分，政府每年再按不低于人均60元给予补助，其中，中央财政对中西部地区按人均30元给予补助。中央财政对东部地区参照新型农村合作医疗的补助办法给予适当补助。财政补助的具体方案由财政部门商劳动保障、民政等部门研究确定，补助经费要纳入各级政府的财政预算。
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