The impact of medical insurance on family financial support : evidence from CHARLS in China

Background In China, public medical insurance has expanded rapidly in the past 20 years. Many studies have discussed the benefts of medical insurance in improving residents' health and fnancial stability, and increasing the utilization of medical services. Less attention is paid to the efect of medical insurance on family support between parents and children. This study focuses on the efect of medical insurance on promoting family fnancial support in China. Method Fifty-fve thousand sixty-two individual samples were obtained from four waves of the China Health and Retirement Longitudinal Study (CHARLS): 2011, 2013, 2015 and 2018. Linear-regression model and propensity score matching are used to determine the relationship between medical insurance and family fnancial support. Then, mediation model is introduced to identify the mediation mechanisms. Also, moderation model is used to estimate the moderation efect of parental education and health. Results Medical insurance has signifcantly increased family fnancial support between the insured parents and their children. Moreover, this positive efect is heterogeneous since only families living in rural areas were afected, and the direction of family fnancial support changed with the aging of the parents. The welfare of medical insurance on fnancial status have also been proven in this paper. The results indicate that medical insurance reduces the out-ofpocket ratio of medical expenses and increases health investment, which can perform as as two mediation mechanisms to afect family fnancial support. Besides, the education and health status of the insured parents play a role in moderating the efect of medical insurance.