Public and Commercial Medical Insurance Enrollment Rates of Rural-to-Urban Migrants in China

Abstract

Objectives: Large-scale rural-to-urban migration of China has provoked heated discussion about the health of migrants and whether they have equal access to the health resources. This article aimed to compare the public and commercial medical insurance enrollment rates between temporary, permanent migrants and urban natives. Methods: Average marginal effects (AME) of the weighted logistic regression models using 2017 China General Social Survey from 2,068 urban natives, 1,285 temporary migrants, and 1,295 permanent migrants. Results: After controlling for the demographic and socio-economic characteristics, our results show that while the temporary and permanent migrants have a similar public insurance enrollment rate compared with the urban natives, both temporary and permanent migrants have significantly lower commercial insurance enrollment rates (7.5 and 5.3%, respectively) compared with the urban natives. Conclusions: The results highlight significant institutional barriers preventing the temporary migrants from gaining access to public medical insurance and the adverse impact of disadvantaged socio-economic backgrounds on the access of temporary migrants to both public and commercial insurance.

Keywords: China; commercial medical insurance; public health; public medical insurance; rural-to- urban migrants.