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Why would authoritarian leaders expand social welfare provision in the absence of democratization? How do authoritarian leaders design and enforce social welfare expansion in a decentralized multilevel governance setting? This book identifies the trade-off authoritarian leaders face in social welfare provision: effectively balancing coverage and benefits between elites and masses in order to maximize the regime's survival prospects. Using government documents, field interviews, survey data, and government statistics about Chinese social health insurance, this book reveals that Chinese authoritarian leaders attempt to manage the distributive trade-off by a "stratified expansion" strategy, establishing an expansive yet stratified social health insurance system to perpetuate a particularly privileged program for the elites while building an essentially modest health provision for the masses.

Introduction -- Theory of stratified expansion of social welfare -- Overview of China's social health insurance -- The center's distributive strategy and fund allocation -- Local motivation and distributive choices -- Understanding subnational variation in Chinese social health insurance -- Who gets what, when and how from Chinese social health insurance expansion? -- Conclusion.