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The Effects of Health Insurance within Families: Experimental Evidence from Nicaragua

Author

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  • Anne Fitzpatrick
  • Rebecca Thornton

Abstract

This paper measures the causal effects of parent enrollment into voluntary health insurance on healthcare utilization among insured and uninsured children in Nicaragua. The study utilizes a randomized trial and age-eligibility cutoff in which insurance subsidies were randomly allocated to parents that covered their dependent children under 12; children age 12 and older were not eligible for coverage. Among eligible children, the insurance increased utilization at covered providers by 0.56 visits and increased overall utilization by 1.3 visits. Ineligible children with insured parents experienced 1.7 fewer healthcare visits driven by parent, not sibling, enrollment. The results suggest complementarities across healthcare provider type and provide evidence that households reallocate resources across all members in response to changes in healthcare prices for some.

Suggested Citation

  • Anne Fitzpatrick & Rebecca Thornton, 2019. "The Effects of Health Insurance within Families: Experimental Evidence from Nicaragua," The World Bank Economic Review, World Bank, vol. 33(3), pages 736-749.
  • Handle: RePEc:oup:wbecrv:v:33:y:2019:i:3:p:736-749.
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    File URL: http://hdl.handle.net/10.1093/wber/lhx012
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    Cited by:

    1. Banerjee, Abhijit & Finkelstein, Amy & Hanna, Rema & Olken, Benjamin & Ornaghi, Arianna & Sumarto, Sudarno, 2020. "Subsidies and the Dynamics of Selection:Experimental Evidence from Indonesia's National Health Insurance," CAGE Online Working Paper Series 454, Competitive Advantage in the Global Economy (CAGE).
    2. Abhijit Banerjee & Amy Finkelstein & Rema Hanna & Benjamin A. Olken & Arianna Ornaghi & Sudarno Sumarto, 2019. "The Challenges of Universal Health Insurance in Developing Countries: Evidence from a Large-scale Randomized Experiment in Indonesia," NBER Working Papers 26204, National Bureau of Economic Research, Inc.
    3. Rabbani, Atonu & Mehareen, Jeenat & Chowdhury, Imran Ahmed & Sarker, Malabika, 2022. "Mandatory employer-sponsored health financing scheme for semiformal workers in Bangladesh: An experimental assessment," Social Science & Medicine, Elsevier, vol. 292(C).
    4. Abhijit Banerjee & Rema Hanna & Benjamin A Olken & Sudarno Sumarto, "undated". "The Challenges of Universal Health Insurance in Developing Countries: Evidence from a Large-scale Randomized Experiment in Indonesia," Working Papers 1994, Publications Department.

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