Redistributive effects of China's urban–rural resident basic medical insurance: a theoretical model and empirical analysis

URRBMI still faces three key challenges: the contribution mechanism is not income-related, benefit packages vary markedly, and the fund relies heavily on fiscal transfers while exhibiting limited risk-pooling capacity. To enhance redistributive effectiveness, we recommend mandatory enrolment with income-proportional contributions, higher benefit levels, and raising the pooling level of the basic medical insurance fund, while merging the urban employee basic medical insurance scheme with the urban and rural residents' basic medical insurance scheme.