Unintended Spillovers of Targeted Health Insurance on Intra-household Resource Allocations

The last three decades have seen an increase in the number of targeted health insurance programmes being implemented in developing countries. However, little is known about their intra-household impacts on household members who are not the intended beneficiaries. Using variation introduced by a universal health insurance programme targeted to children below the age of six in Vietnam, I assess the programme’s impacts on expenditures and labour supply of ineligible children. I find that beneficiary households decrease spending on health and education and decrease leisure time for ineligible children relative to non-beneficiary households after the programme is introduced. These results provide new evidence to the intra-household literature on unintended impacts of targeted programmes on resource allocations for children who are not eligible. They also call to attention, the need for concurrent interventions for older children when implementing early life health interventions in developing countries.