Insurance Expansion During Pregnancy.

Area of Science:

• Health Economics
• Public Health Policy
• Maternal and Child Health

Background:

• Cost-sharing in health insurance is a common tool to control healthcare expenditure.
• The impact of eliminating cost-sharing on healthcare utilization and health outcomes, especially for vulnerable populations, remains under-researched.
• Understanding these effects is crucial for designing equitable and efficient health policies.

Purpose of the Study:

• To analyze the impact of Switzerland's abolition of cost-sharing for pregnant women on healthcare spending.
• To investigate differential effects across income groups and specific healthcare services.
• To assess the policy's influence on maternal and newborn health outcomes.

Main Methods:

• Utilized an exogenous policy change in Switzerland regarding health insurance cost-sharing for pregnant women.
• Employed non-linear regression analysis to examine changes in gross healthcare spending.
• Analyzed demand responses for specific services like physiotherapy and laboratory services, stratified by income level.

Main Results:

• The policy led to a slight increase in average gross healthcare spending, contrary to expectations of no demand impact.
• Significant demand increases were observed for physiotherapy and laboratory services, especially among individuals with below-median income (physiotherapy up by 50%).
• Suggestive evidence indicated improved newborn health for lower-income groups, but no impact on maternal health was found.

Conclusions:

• Eliminating cost-sharing can stimulate healthcare demand, particularly for specific services and lower-income populations.
• Health insurance cost-sharing policies necessitate balancing cost-containment goals with health and equity considerations.
• The findings underscore the importance of considering distributional impacts when reforming health insurance policies.