Does participating in health insurance benefit the migrant workers in China? An empirical investigation

Rural-to-urban migrant workers are an under-represented group in China's health insurance system, and the status of their health and healthcare draws increasing attention. This paper uses the 2007–2010 State Council URBMI Household Survey data to evaluate the efficacy of major health insurance programs in improving the accessibility, affordability and appropriateness of healthcare among migrant workers. Based on the instrumental variable (IV) estimation that accounts for the endogeneity of insurance participation, we find that the Urban Employee Basic Medical Insurance (UEBMI) is most effective in promoting physical exams and improving self-rated health status for migrant workers, while the New Rural Cooperative Medical Scheme (NRCMS), the Urban Resident Basic Medical Insurance (URBMI) and commercial insurance show significant benefits in boosting preventive care utilization. However, the current programs are not effective in alleviating the financial burden of healthcare and promoting formal medical utilization among migrant workers, possibly due to the lack of systematic financing scheme for outpatient treatment and the segmentation between insurance platforms. Our study provides implications on reforming China's medical insurance system and migrant health policies.