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Does Expanding Health Insurance Beyond Formal-Sector Workers Encourage Informality? Measuring the Impact of Mexico's Seguro Popular

By Reyes Aterido, Mary Hallward-Driemeier and Carmen Pagés

Abstract

Seguro Popular (SP) was introduced in 2002 to provide health insurance to the 50 million Mexicans without Social Security. This paper tests whether the program has had unintended consequences, distorting workers' incentives to operate in the informal sector. The analysis examines the impact of SP on disaggregated labor market decisions, taking into account that program coverage depends not only on the individual's employment status, but also on that of other household members. The identification strategy relies on the variation in SP's rollout across municipalities and time, with the difference-in-difference estimation controlling for household fixed effects. The paper finds that SP lowers formality by 0.4-0.7 percentage points, with adjustments largely occurring within a few years of the program's introduction. Rather than encouraging exit from the formal sector, SP is associated with a 3.1 percentage point reduction (a 20 percent decline) in the inflow of workers into formality. Income effects are also apparent, with significantly decreased flows out of unemployment and lower labor force participation. The impact is larger for those with less education, in larger households, and with somebody else in the household guaranteeing Social Security coverage. However, workers pay for part of these benefits with lower wages in the informal sector.informality, Seguro Popular, Mexico, non-contributory social programs, social assistance

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Citations

  1. (2007). A Politically Robust Experimental Design for Public Policy Evaluation, with Application to the Mexican Universal Health Insurance Program.”
  2. (2008). Are Informal Workers Compensated for the Lack of Fringe Benefits? Free Health Care as an Instrument for Formality.” Working Papers 0804 Centro de Investigación Económica,
  3. (1999). Does Informality Imply Segmentation in the Urban Labor Markets? Evidence from Sectoral Transitions in Mexico.” World Bank Economic Review
  4. (2008). Good Intentions, Bad Outcomes, Social Policy,
  5. (2006). Gross Workers Flows in the Presence of Informal Labor Markets: the Mexican Experience 1987-2002.” Policy Research Working Paper Series #3883. The World Bank.
  6. (2004). How Much should we Trust Difference in Differences Estimates?”
  7. (2011). Informality and the Expansion of Social Protection Programs, Evidence from
  8. (2004). Informality Revisited.” World Development
  9. (2008). Is Informality a Good Measure of Job Quality? Evidence from Job Satisfaction Data.” Research Department Working Paper #654. Inter-American Development Bank.
  10. (2007). Labor informality effects of a poverty-alleviation program.” Mimeo.
  11. (2009). No Education, No Good Jobs? Evidence on the Relationship between Education and Labor Market Segmentation.”
  12. (2006). Seguro Popular Incidence Analysis. Decentralized Service Delivery for the Poor.” Vol. II.” World Bank.
  13. (2008). Social Protection Programs and Employment: The Case of Mexico’s Seguro Popular Program.” Mimeo.
  14. (2011). The Short Term Causal Effects of Seguro Popular on Formal Employment.” Mimeo.
  15. (2008). Wealthier but not much Healthier: Effects of a Health Insurance Program for the Poor in Mexico.” Mimeo.

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