Summary (English)

In 2003, China launched a heavily subsidized voluntary health insurance program for rural residents. We analyze factors affecting enrollment and combine differences-in-differences with matching methods to obtain impact estimates. We use data collected from program administrators, health facilities and households. Enrollment is lower among poor households, and higher among households with chronically sick members. The scheme has increased outpatient and inpatient utilization (by 20-30%), but has had no impact on out-of-pocket spending or on utilization among the poor. The program has increased ownership of expensive equipment among central township health centers but has had no impact on cost per case.