The 2009 Health Care Reform and Insurance Coverage for Migrant Construction Workers in Beijing, China

By the year 2020, China aims to achieve universal health care coverage. The most recent health care reform was passed in 2009. With three major health care insurance schemes already in place at this time, the Central Government has had success in insuring urban residents, urban employees, and rural residents. However, one of the most vulnerable populations remains inadequately insured and unseen: the migrant construction worker. They are both rural-­‐urban migrants who cannot access many urban health care resources because of their rural hukou, as well as the severely disenfranchised temporary laborers at the lowest-­‐rung of the construction industry. Standing at the intersection of two highly vulnerable and invisible populations, migrant construction workers are at compounded risk of entirely slipping past any formal health care infrastructure. Thus, this paper seeks to investigate how the most recent 2009 health care reform has attempted to capture this doubly vulnerable population within the formal health care system. I conducted interviews with migrant construction workers in Beijing, interviewed scholars, and complimented my findings with data extracted from the China Health and Nutrition Survey. I found that migrant construction workers tended not to be aware of the services they can access or the benefits to which they have a right, nor were they highly interested in obtaining them; there more pressing issues toworry about such as financial security. However, these findings are compounded by a highly complex social,economic, and political context. Although legal tools do exist to reinforce labor laws, it often requires time,knowledge of the convoluted legal system, and political savvy to successfully use them, none of which a migrant construction worker is likely to have. Thus, construction migrant workers lie at the intersection of two disenfranchised groups making them especially invisible to the political eye.