Expanding Health Insurance for the Elderly of the Philippines

The Philippines expanded health insurance coverage of its senior citizens, aged 60 and older, in 2014. Employing data from two separate sources, we find that the expansion increased insurance coverage by approximately 16 percentage points. Instrumental variables estimates indicate that out-of-pocket medical expenditures more than doubled among the newly insured. We argue that this is most likely driven by an outward shift in the medical demand curve due to physician-induced demand. Quantile regression estimates indicate that these effects were the most pronounced among high utilizers. We show that the compliers, defined as those induced by the policy to obtain insurance, are disproportionately female and largely from the middle of the socioeconomic distribution. Finally, tests for selection indicate only moderate adverse selection into the treatment.