Migrant children's take-up of social health insurance: Experimental evidence from China

There is mounting evidence on the importance of health insurance for children's health and well-being. However, many disadvantaged families do not enroll their eligible children in social health insurance programs. This study examines the effectiveness of interventions aimed at increasing social health insurance enrollment for disadvantaged migrant children in Guangzhou, China. We conducted a two-stage randomized controlled trial with a 3 x 2 design: (1) randomly assigning parents to a control group or one of two treatment groups, where they received digital information on eligibility or eligibility plus comparative benefits and costs; and (2) nudging half of the parents with text message reminders about the enrollment deadline. Informing parents about eligibility alone did not have any impact. However, providing information on eligibility plus comparative benefits and costs increased enrollment in social health insurance in Guangzhou by over 44% (9.4 percentage points). Nudging produced no significant impact. Exploiting treatment group assignment as an instrument for coverage, we were unable to detect any positive effects of having social health insurance in the first year after the intervention.