Means-tested complementary health insurance and healthcare utilisation in France: Evidence from a low-income population

This paper assesses the impact of a free complementary health insurance plan introduced in 2000 in France on healthcare utilisation and healthcare expenditures. This free plan pays off most of out-of-pocket expenses and is entitled to the 10% poorest households in France. In order to tackle the endogeneity issue of the complementary health insurance variable, we use information on the selection rule to qualify for the free plan and adopt a regression discontinuity approach using eligibility (family income below the cut-off value) as an instrument variable. First findings show a significant effect of the free plan on the number of doctor visits, especially on the number of GP visits and on healthcare expenditures. However, we do not find any impact on the likelihood of seeing a doctor and on the number of specialist visits.