Do Prices Matter for Healthcare Accessibility? Evidence From a Means-Tested Complementary Health Insurance in France

In France, the Couverture Maladie Universelle Complémentaire (CMU-C) scheme is a means-tested, state-financed, complementary health insurance program that fully covers healthcare. Using administrative claims data and a staggered difference-in-differences approach, we estimate the impact of enrollment in the program on healthcare utilization. To address selection into the program, we use health shocks at the family level to exogenize individual enrollment. The findings indicate that access to free healthcare significantly increases healthcare utilization at both intensive and extensive margins. This effect is driven primarily by individuals who are uninsured before enrolling in the CMU-C. Moreover, individuals with severe or chronic illnesses, who already receive additional public coverage for their conditions, experience significant gains from the CMU-C coverage. Finally, these effects persist throughout the coverage period.