Japan is poised to eliminate out-of-pocket costs for childbirth under an expanded public health insurance initiative, as policymakers race to slow country’s declining birth rate.
Why It Matters
The number of babies born in Japan fell for the 10th straight year in 2025. The trend accelerated despite more than $20 billion in annual pro-natal measures in recent years, with births dropping below 710,000—a milestone that wasn’t expected until 2042.
Rising costs of living, along with a disproportionate share of child-rearing responsibilities borne by women, are frequently cited factors in the decision to delay or forgo child rearing.
Newsweek has reached out to the office of Japanese Prime Minister Sanae Takaichi by email with a request for comment.
What To Know
The new initiative would introduce a standardized fee for childbirth, to be fully covered by public health insurance, offering significant financial relief to mothers nationwide under a plan approved earlier this month by Japan’s Cabinet.
Under the current system, mothers receive a lump-sum payment of 500,000 yen ($3,130) per birth, which often falls short. Delivery fees vary widely by region, with Tokyo the most expensive at an average of 648,000 yen in 2024, according to The Japan Times.
Women undergoing cesarean sections, classified as medical procedures, currently receive partial coverage but must still pay 30 percent of the cost.
The government is targeting rollout of the new system by fiscal 2028, but has avoided setting a firm implementation deadline to limit the impact on medical providers from a sudden drop in fees. The 500,000-yen allowance will remain in place in the interim.
The Japan Association of Obstetricians and Gynecologists has warned that a standardized price could worsen financial pressures on clinics and hospitals, particularly in regions already hard-hit by depopulation, The Asahi Shimbun reported.
The Cabinet also approved plans to expand out-of-pocket payments for certain prescription drugs with over-the-counter equivalents, such as common fever medications, to reduce strain on the tax-funded health care system. Children and patients with intractable illnesses will be exempt from the change, which is slated for introduction by March 2027.
The proposals will be introduced as bills and put to debate in parliament.
All residents of Japan are required to enroll in the public health system, which operates through two main plans: Employees’ Health Insurance for salaried workers and their dependents, and National Health Insurance for the self-employed, retirees, and others.
Combined, the programs provide coverage to more than 98 percent of the population.
Japan’s rapidly aging population is placing increasing strain on social welfare systems and raising concerns about the long-term sustainability of the world’s fourth-largest economy. Officials have warned that the country has until around 2030 to reverse the trend.
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