Effects of urban-rural medical insurance integration on health: Evidence from rural China

Urban-rural medical insurance integration aims to raise the medical insurance reimbursements for rural residents and ultimately improve their health. Using China Family Panel Studies (CFPS) from 2010 to 2018, we employ a time-varying difference-in-differences (DID) model to identify the impact of urban-rural medical insurance integration on the physical and mental health of the middle-aged and elderly in rural areas. We find that urban-rural medical insurance integration significantly improves physical and mental health of middle-aged and elderly in rural areas, and this positive effect exists for a long time. The improvement of health can be attributed to the release of medical needs, the decrease in the medical burden and the increase in the trust in doctors. Then, we find that urban-rural medical insurance integration also has indirect effect, that is, the integration significantly increases the willingness to enroll in insurance of rural middle-aged and elderly individuals with low incomes, which could result in increased access to health services and their health. Finally, the village committee’s regular announcement changes of medical insurance policy can strengthen the positive impact of the policy on the health.