IDEAS home Printed from https://ideas.repec.org/a/eee/ecmode/v155y2026ics026499932500392x.html

Long-term care insurance and reemployment among middle-aged and elderly retirees: Evidence from China

Author

Listed:
  • Cheng, Qian
  • Guo, Junru
  • Li, Yue
  • Chen, Yongli
  • Ni, Xin

Abstract

As population aging accelerates, sustaining economic and social development requires social security reforms that enhance older adults' participation and unlock their labor potential. Using China's Long-Term Care Insurance (LTCI) pilot as a quasi-natural experiment, this study empirically examines LTCI's effect on the reemployment of middle-aged and elderly retirees. Results show that LTCI significantly boosts reemployment, increasing the likelihood of returning to work, raising rates of contract-based employment, and reducing reliance on self-employment. These effects vary across household, policy, and regional dimensions. Mechanism analysis indicates that LTCI promotes reemployment mainly by easing informal caregiving burdens and fostering the care service industry. The findings provide new evidence on the labor market implications of social care policies and highlight LTCI's role in advancing active aging and labor force engagement in aging societies.

Suggested Citation

  • Cheng, Qian & Guo, Junru & Li, Yue & Chen, Yongli & Ni, Xin, 2026. "Long-term care insurance and reemployment among middle-aged and elderly retirees: Evidence from China," Economic Modelling, Elsevier, vol. 155(C).
  • Handle: RePEc:eee:ecmode:v:155:y:2026:i:c:s026499932500392x
    DOI: 10.1016/j.econmod.2025.107397
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S026499932500392X
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.econmod.2025.107397?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Ai, Jingyi & Feng, Jin & Zhang, Xiaohan, 2024. "Long-term care insurance coverage and labor force participation of older people: Evidence from China," China Economic Review, Elsevier, vol. 86(C).
    2. Laura Crespo & Pedro Mira, 2014. "Caregiving to Elderly Parents and Employment Status of European Mature Women," The Review of Economics and Statistics, MIT Press, vol. 96(4), pages 693-709, October.
    3. A. Smith, Jeffrey & E. Todd, Petra, 2005. "Does matching overcome LaLonde's critique of nonexperimental estimators?," Journal of Econometrics, Elsevier, vol. 125(1-2), pages 305-353.
    4. Meghan M. Skira, 2015. "Dynamic Wage And Employment Effects Of Elder Parent Care," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 56, pages 63-93, February.
    5. Schmitz, Hendrik & Westphal, Matthias, 2017. "Informal care and long-term labor market outcomes," Journal of Health Economics, Elsevier, vol. 56(C), pages 1-18.
    6. Sebnem Kalemli-Ozcan & David Weil, 2010. "Mortality change, the uncertainty effect, and retirement," Journal of Economic Growth, Springer, vol. 15(1), pages 65-91, March.
    7. Rie Fujisawa & Francesca Colombo, 2009. "The Long-Term Care Workforce: Overview and Strategies to Adapt Supply to a Growing Demand," OECD Health Working Papers 44, OECD Publishing.
    8. Sohn, Minsung & O'Campo, Patricia & Muntaner, Carles & Chung, Haejoo & Choi, Mankyu, 2020. "Has the long-term care insurance resolved disparities in mortality for older Koreans? examination of service type and income level," Social Science & Medicine, Elsevier, vol. 247(C).
    9. Ryotaro Fukahori & Tadashi Sakai & Kazuma Sato, 2015. "The Effects of Incidence of Care Needs in Households on Employment, Subjective Health, and Life Satisfaction among Middle-aged Family Members," Scottish Journal of Political Economy, Scottish Economic Society, vol. 62(5), pages 518-545, November.
    10. Jingyi Wang & Jing Guan & Guojun Wang, 2023. "Impact of long‐term care insurance on the health status of middle‐aged and older adults," Health Economics, John Wiley & Sons, Ltd., vol. 32(3), pages 558-573, March.
    11. K. Bolin & B. Lindgren & P. Lundborg, 2008. "Informal and formal care among single‐living elderly in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 393-409, March.
    12. Heger, Dörte, 2014. "Work and Well-Being of Informal Caregivers in Europe," Ruhr Economic Papers 512, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    13. Feng, Jin & Wang, Zhen & Yu, Yangyang, 2020. "Does long-term care insurance reduce hospital utilization and medical expenditures? Evidence from China," Social Science & Medicine, Elsevier, vol. 258(C).
    14. Kondo, Ayako, 2019. "Impact of increased long-term care insurance payments on employment and wages in formal long-term care," Journal of the Japanese and International Economies, Elsevier, vol. 53(C), pages 1-1.
    15. Reljic, Jelena & Zezza, Francesco, 2025. "Breaking the divide: Can public spending on social infrastructure boost female employment in Italy?," Economic Modelling, Elsevier, vol. 143(C).
    16. Laun, Lisa, 2017. "The effect of age-targeted tax credits on labor force participation of older workers," Journal of Public Economics, Elsevier, vol. 152(C), pages 102-118.
    17. Kim, Hyuncheol Bryant & Lim, Wilfredo, 2015. "Long-term care insurance, informal care, and medical expenditures," Journal of Public Economics, Elsevier, vol. 125(C), pages 128-142.
    18. David M. Blau & Ryan M. Goodstein, 2010. "Can Social Security Explain Trends in Labor Force Participation of Older Men in the United States?," Journal of Human Resources, University of Wisconsin Press, vol. 45(2).
    19. John Rust & Christopher Phelan, 1997. "How Social Security and Medicare Affect Retirement Behavior in a World of Incomplete Markets," Econometrica, Econometric Society, vol. 65(4), pages 781-832, July.
    20. Boyle, Melissa A. & Lahey, Joanna N., 2010. "Health insurance and the labor supply decisions of older workers: Evidence from a U.S. Department of Veterans Affairs expansion," Journal of Public Economics, Elsevier, vol. 94(7-8), pages 467-478, August.
    21. Charles, Kerwin Kofi & Sevak, Purvi, 2005. "Can family caregiving substitute for nursing home care?," Journal of Health Economics, Elsevier, vol. 24(6), pages 1174-1190, November.
    22. Fu, Rong & Noguchi, Haruko & Kawamura, Akira & Takahashi, Hideto & Tamiya, Nanako, 2017. "Spillover effect of Japanese long-term care insurance as an employment promotion policy for family caregivers," Journal of Health Economics, Elsevier, vol. 56(C), pages 103-112.
    23. Liu, Hong & Ma, Jinqiu & Zhao, Liqiu, 2023. "Public long-term care insurance and consumption of elderly households: Evidence from China," Journal of Health Economics, Elsevier, vol. 90(C).
    24. Lei, Xiaoyan & Bai, Chen & Hong, Jingpeng & Liu, Hong, 2022. "Long-term care insurance and the well-being of older adults and their families: Evidence from China," Social Science & Medicine, Elsevier, vol. 296(C).
    25. Meghan M. Skira, 2015. "Dynamic Wage And Employment Effects Of Elder Parent Care," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 56(1), pages 63-93, February.
    26. Tammy Schirle, 2008. "Why Have the Labor Force Participation Rates of Older Men Increased since the Mid-1990s?," Journal of Labor Economics, University of Chicago Press, vol. 26(4), pages 549-594, October.
    27. Shao, Zhanqiang & Chen, Chen, 2024. "Impact of long-term care insurance on the financial asset allocation of middle-aged and elderly households: Evidence from China," International Review of Financial Analysis, Elsevier, vol. 95(PC).
    28. Lu, Bei & Liu, Xiaoting & Lim, Jonathan & Yang, Mingxu, 2019. "Changes in the morbidity prevalence and morbidity-free life expectancy of the elderly population in China from 2000 to 2010," The Journal of the Economics of Ageing, Elsevier, vol. 13(C), pages 113-121.
    29. Zhu, Chen & Jin, Zhuo & Lee, Chien-Chiang, 2022. "The impact of informal care from children to their elderly parents on self-employment? Evidence from China," Economic Modelling, Elsevier, vol. 117(C).
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Lin, Lin & He, Min & Sun, Wenkai, 2025. "Security fosters generosity: Social security protection and charitable giving," World Development, Elsevier, vol. 196(C).
    2. Lin, Lin & He, Min & Nie, Peng, 2025. "Direct and spillover effects of long-term care insurance on Chinese elderly frailty," The Journal of the Economics of Ageing, Elsevier, vol. 31(C).
    3. Korfhage, Thorben & Fischer-Weckemann, Björn, 2024. "Long-run consequences of informal elderly care and implications of public long-term care insurance," Journal of Health Economics, Elsevier, vol. 96(C).
    4. Ai, Jingyi & Feng, Jin & Zhang, Xiaohan, 2024. "Long-term care insurance coverage and labor force participation of older people: Evidence from China," China Economic Review, Elsevier, vol. 86(C).
    5. Zhang, Chunfeng & Lei, Xiaoyan, 2025. "Home or institution: A comparative analysis of elderly care efficacy in China," Journal of Asian Economics, Elsevier, vol. 98(C).
    6. Tianli Yang & Zhong Zhao, 2025. "Public Long‐Term Care Insurance and Retirement Intentions of Urban Workers: Evidence From China," Health Economics, John Wiley & Sons, Ltd., vol. 34(9), pages 1537-1559, September.
    7. Han, Xiao & Liu, Zining & Zheng, Wei, 2025. "Does public long-term care insurance affect spousal labor supply? Evidence from China," Economic Modelling, Elsevier, vol. 153(C).
    8. Guo, Miao & Li, Yang & Zhang, Wendan, 2025. "Supply expansion of Long-Term Services & Supports: Evidence from China’s long-term care insurance pilot," Journal of Economic Behavior & Organization, Elsevier, vol. 239(C).
    9. Yang, Tianli & Zhao, Zhong, 2025. "Long-term care insurance policy and the development of elderly care enterprises in China," China Economic Review, Elsevier, vol. 94(PB).
    10. Miao Guo & Yang Li & Minghao Wu & Terence C. Cheng, 2024. "Services and Cash: How Long-term Care Insurance Benefit Design Affects Household Behavior in China," Papers 2024-13, Centre for Health Economics, Monash University.
    11. Hollingsworth, Bruce & Ohinata, Asako & Picchio, Matteo & Walker, Ian, 2022. "Does It Matter Who Cares for You? The Effect of Substituting Informal with Formal Personal Care on the Care Recipients' Health," IZA Discussion Papers 15457, IZA Network @ LISER.
    12. Costa-Font, Joan & Jiménez-Martín, Sergi & Vilaplana-Prieto, Cristina, 2022. "Do Public Caregiving Subsidies and Supports affect the Provision of Care and Transfers?," Journal of Health Economics, Elsevier, vol. 84(C).
    13. Minamo MIKOSHIBA, 2025. "Universal Insurance with In-kind Transfers: The welfare effects of long-term care insurance in Japan," Discussion papers 25030, Research Institute of Economy, Trade and Industry (RIETI).
    14. Jiayi Wen & Xiaoqing Yu, 2024. "Insuring Long-Term Care in Developing Countries: The Interaction between Formal and Informal Insurance," Papers 2408.14243, arXiv.org.
    15. Rellstab, Sara & Bakx, Pieter & García-Gómez, Pilar & van Doorslaer, Eddy, 2020. "The kids are alright - labour market effects of unexpected parental hospitalisations in the Netherlands," Journal of Health Economics, Elsevier, vol. 69(C).
    16. Simard-Duplain, Gaëlle, 2022. "Heterogeneity in informal care intensity and its impact on employment," Journal of Health Economics, Elsevier, vol. 86(C).
    17. Heger, Dörte & Korfhage, Thorben, 2017. "Does the negative effect of caregiving on work persist over time?," Ruhr Economic Papers 703, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    18. Kolodziej, Ingo & Coe, Norma B. & Van Houtven, Courtney Harold, 2023. "Intensive informal care and impairments in work productivity and activity," Ruhr Economic Papers 1010, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    19. Liangwen Zhang & Jinghong Dong & Sicheng Li & Ya Fang, 2026. "The effect of long-term care insurance on labor force participation among informal caregivers: evidence from China," Humanities and Social Sciences Communications, Palgrave Macmillan, vol. 13(1), pages 1-11, December.
    20. Akira Yakita, 2024. "Old-age support policy and fertility with strategic bequest motives," Journal of Population Economics, Springer;European Society for Population Economics, vol. 37(2), pages 1-23, June.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:ecmode:v:155:y:2026:i:c:s026499932500392x. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/30411 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.