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Who Benefits From Free Health Insurance: Evidence from Mexico

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Abstract

We present the first comprehensive evidence on the health impacts of the introduction and expansion of a large non-contributory health insurance program in Mexico, the Seguro Popular (SP). SP provided access to health services without co-pays to individuals with no Social Security protection. To identify the impacts of the program we use its staggered rollout across municipalities between 2002 and 2010. Our intent-to-treat estimates show that SP reduced infant mortality by 10% in poor municipalities. We are unable to detect program impacts on mortality for children ages 1-4, adults or elderly. The decline in infant mortality is driven by reductions in deaths due to perinatal conditions, congenital malformations, diarrhea and respiratory infections. Also in poor municipalities, the introduction of SP is associated with an immediate 7% increase in obstetric-related hospital admissions and with a 6% increase in hospital admissions due to diarrhea and respiratory infections among infants. The decline in infant mortality attributed to SP closes 84% of the gap in infant mortality rates between poor and rich Mexican municipalities.

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  • Conti, Gabriella & Ginja, Rita, 2017. "Who Benefits From Free Health Insurance: Evidence from Mexico," Working Papers in Economics 18/17, University of Bergen, Department of Economics.
    • Handle: RePEc:hhs:bergec:2017_018
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    Cited by:

    1. Anaka Aiyar & Naveen Sunder, 2024. "Health insurance and child mortality: Evidence from India," Health Economics, John Wiley & Sons, Ltd., vol. 33(5), pages 870-893, May.
    2. Patrick Opoku Asuming & Hyuncheol Bryant Kim & Armand Sim, 2024. "Selection and behavioral responses of health insurance subsidies in the long run: Evidence from a field experiment in Ghana," Health Economics, John Wiley & Sons, Ltd., vol. 33(5), pages 992-1032, May.
    3. Miguel Angel Carpio & Lucero Gomez & Pablo Lavado, 2025. "The Impact of Social Health Insurance on Student Performance: Evidence From an RDD in Peru," Health Economics, John Wiley & Sons, Ltd., vol. 34(7), pages 1309-1325, July.
    4. Jonah S. Goldberg, 2023. "What we measure when we measure the effects of user fees: a replication, reanalysis, and extension of Tanaka, 2014," Empirical Economics, Springer, vol. 65(4), pages 1981-2009, October.
    5. del Valle, Alejandro, 2021. "The effects of public health insurance in labor markets with informal jobs: Evidence from Mexico," Journal of Health Economics, Elsevier, vol. 77(C).
    6. Giancarlo Buitrago & Paul Andrés Rodríguez-Lesmes & Natalia Serna & Marcos Vera-Hernández, 2023. "The Role of Hospital Networks in Individual Mortality," Documentos de Trabajo 20945, Universidad del Rosario.
    7. Font-Gilabert, Paulino, 2020. "Taking cover: human capital accumulation in the presence of shocks and health insurance," ISER Working Paper Series 2020-16, Institute for Social and Economic Research.
    8. Jinfang Tian & Yunjing Wang & Siyang Sun, 2024. "RETRACTED ARTICLE: Two Sides of a Coin: Digital Economy and the Supply of Basic Public Services," Journal of the Knowledge Economy, Springer;Portland International Center for Management of Engineering and Technology (PICMET), vol. 15(4), pages 16943-16968, December.
    9. Helena Arruda & Rudi Rocha, 2024. "Political Turnover and Fatal Government Transitions," Working Papers 19, Instituto de Estudos para Políticas de Saúde.
    10. Julia Schmieder, 2020. "Fertility as a Driver of Maternal Employment," Discussion Papers of DIW Berlin 1882, DIW Berlin, German Institute for Economic Research.
    11. Shi, Julie & Yang, Wanyu & Yuan, Ye, 2025. "Cover more for less: Targeted drug coverage, chronic disease management, and medical spending," Journal of Development Economics, Elsevier, vol. 172(C).
    12. Bancalari, Antonella & Bernal, Pedro & Celhay, Pablo & Martinez, Sebastian & Sánchez, María Deni, 2024. "An Ounce of Prevention for a Pound of Cure: Basic Health Care and Efficiency in Health Systems," IDB Publications (Working Papers) 13433, Inter-American Development Bank.
    13. Bancalari, Antonella & Berlinski, Samuel & Buitrago, Giancarlo & García, María Fernanda & Mata, Dolores de la & Vera-Hernández, Marcos, 2023. "Health Inequalities in Latin American and the Caribbean: Child, Adolescent, Reproductive, Metabolic Syndrome and Mental Health," IDB Publications (Working Papers) 13158, Inter-American Development Bank.
    14. Paulino Font-Gilabert, 2023. "Taking Cover: Human Capital Accumulation in the Presence of Shocks and Health Insurance," The World Bank Economic Review, World Bank, vol. 37(3), pages 437-459.

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    Keywords

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    JEL classification:

    • H10 - Public Economics - - Structure and Scope of Government - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • O18 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Urban, Rural, Regional, and Transportation Analysis; Housing; Infrastructure

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