Does Health Insurance Coverage Lead to Better Health and Educational Outcomes? Evidence from Rural China

Abstract

Using 2006 China Agricultural Census (CAC), we examine whether the introduction of the New Cooperative Medical System (NCMS) has affected child mortality, maternal mortality, and school enrollment of the 6-16 years olds. Our data cover 5.9 million people living in eight low-income rural counties, of which four adopted the NCMS by 2006 and four did not adopt it until 2007. Raw data suggest that enrolling in NCMS is associated with better school enrollment and lower mortality of young children and pregnant women. However, using a difference-in-difference propensity score method, we find most of these differences are driven by the endogenous introduction and take-up of NCMS, and out method overcomes classical propensity score matching's failure to address the selection bias. While the NCMS does not affect child mortality and maternal mortality, it does help improve the school enrollment of six-year-olds.