Insurance Expansion During Pregnancy

We analyze how the abolition of cost-sharing in health insurance affects pregnant women's gross spending on health care services using an exogenous policy change in Switzerland. Using non-linear regression, we find that the policy slightly increases average gross spending, contrasting policymaker expectations of no impact on demand. More importantly, however, we find strong demand responses for specific types of services (physiotherapy, laboratory services), in particular for below-median income individuals. Within this group, we find that physiotherapy increases as much as 50% in response to the policy change. Additionally, we find suggestive evidence of a relative improvement of newborn health among individuals with below-median income, indicating that additional use of healthcare services may be beneficial. However, we find no evidence of an impact on maternal health. These results highlight that cost-sharing policies-such as the one we examine-need to balance trade-offs between reducing healthcare costs and addressing the health and equity implications of such policies.

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Publication Details

Journal
Health Economics
Published
2025-05-26
DOI
https://doi.org/10.1002/hec.4978
Primary Topic
Healthcare Policy and Management
Type
article
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article

Insurance Expansion During Pregnancy

Philip Hochuli, Christian Schmid
Health Economics
Healthcare Policy and Management
article

Insurance Expansion During Pregnancy

Philip Hochuli, Christian Schmid
article en

Abstract

We analyze how the abolition of cost-sharing in health insurance affects pregnant women's gross spending on health care services using an exogenous policy change in Switzerland. Using non-linear regression, we find that the policy slightly increases average gross spending, contrasting policymaker expectations of no impact on demand. More importantly, however, we find strong demand responses for specific types of services (physiotherapy, laboratory services), in particular for below-median income individuals. Within this group, we find that physiotherapy increases as much as 50% in response to the policy change. Additionally, we find suggestive evidence of a relative improvement of newborn health among individuals with below-median income, indicating that additional use of healthcare services may be beneficial. However, we find no evidence of an impact on maternal health. These results highlight that cost-sharing policies-such as the one we examine-need to balance trade-offs between reducing healthcare costs and addressing the health and equity implications of such policies.

Health EconomicsVol. 34(9)
CSS (Switzerland) (CH)
Openalex Percentile: Top 83%
Healthcare Policy and Management
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