Inadequate Medical Protection for Rural Migrant Workers: An Analysis and Policy Recommendations Based on China's Urban Medical Health Insurance System

Given the significant acceleration of urbanization in China in recent years, this study delves into the various challenges faced by rural migrant workers (RUMWs) in the field of medical insurance. According to this detailed report, although the government has taken multiple measures to improve the medical insurance situation of migrant workers, they still face low participation rates, high reimbursement thresholds, fragmented insurance coverage due to frequent inter provincial mobility, and economic financial constraints. The insufficient integration of cross regional medical insurance funds, delayed updates of reimbursement items, and differences in real-time settlement technology have further increased the medical burden on migrant workers. To this end, this article innovatively proposes a three-dimensional policy optimization framework: implementing income based differentiated payment and subsidy policies, clarifying the relevant legal obligations of platform enterprises, and using blockchain technology to construct a unified national medical insurance catalog. These strategies aim to ensure that migrant workers can fairly enjoy the benefits brought by urbanization and promote China's healthcare system from "nominal inclusiveness" to "substantive fairness and justice".