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Long-run Consequences of Health Insurance Promotion When Mandates are Not Enforceable: Evidence from a Field Experiment in Ghana

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  • Patrick Asuming
  • Hyuncheol Bryant Kim
  • Armand Sim

Abstract

We study long-run selection and treatment effects of a health insurance subsidy in Ghana, where mandates are not enforceable. We randomly provide different levels of subsidy (1/3, 2/3, and full), with follow-up surveys seven months and three years after the initial intervention. We find that a one-time subsidy promotes and sustains insurance enrollment for all treatment groups, but long-run health care service utilization increases only for the partial subsidy groups. We find evidence that selection explains this pattern: those who were enrolled due to the subsidy, especially the partial subsidy, are more ill and have greater health care utilization.

Suggested Citation

  • Patrick Asuming & Hyuncheol Bryant Kim & Armand Sim, 2018. "Long-run Consequences of Health Insurance Promotion When Mandates are Not Enforceable: Evidence from a Field Experiment in Ghana," Papers 1811.09004, arXiv.org, revised Jun 2019.
    • Handle: RePEc:arx:papers:1811.09004
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    2. Anup Malani & Cynthia Kinnan & Gabriella Conti & Kosuke Imai & Morgen Miller & Shailender Swaminathan & Alessandra Voena & Bartosz Woda, 2024. "Evaluating pricing health insurance in lower-income countries: A field experiment in India," IFS Working Papers W24/33, Institute for Fiscal Studies.
    3. 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.
    4. 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).
    5. Abhijit Banerjee & Rema Hanna & Benjamin A Olken & Sudarno Sumarto, "undated". "Tantangan Jaminan Kesehatan Semesta di Negara Berkembang: Bukti dari Eksperimen Acak Skala Besar di Indonesia," Working Papers 3526, Publications Department.

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