城乡居民医保整合对农民工城镇定居意愿的影响研究

Research on the Impact of Urban and Rural Residents’Medical Insurance Integration on Migrant Workers’Willingness to Settle in Urban Areas

随着“双循环”新发展格局的逐步构建,让资源要素在城乡之间自由流动是推动城乡一体化的关键举措。以城乡居民医保整合为准自然实验,运用中国劳动力动态调查(CLDS)数据,采用渐进性双重差分法和双重差分倾向得分匹配法,实证研究整合城乡居民医保制度对农民工城镇定居意愿的影响。研究发现:城乡居民医保整合显著降低了农民工定居城镇的意愿,特别是跨市流动农民工定居城镇的意愿,“一制多档”的整合模式也对农民工城镇定居意愿产生了负向激励效应,但随着整合模式由“一制多档”向“城乡一档”过渡,这一负向影响逐渐减弱;城乡居民医保整合及其两种整合模式均仅对低收入组农民工城镇定居意愿有显著的负向影响;城乡居民医保整合对农民工城镇定居意愿的拉回作用呈现显著的代际异质性,其对“老一代”农民工城镇定居意愿的负向效应大于“新生代”农民工,“一制多档”整合模式对两代农民工城镇定居意愿均有显著的抑制作用,而“城乡一档”整合模式仅对“老一代”农民工城镇定居意愿有显著的负向影响。因此,有关决策部门亟需推进以城乡居民医保整合为代表的公共服务均等化改革,逐步提高医疗保险统筹层次,促进城乡要素自由流动,进而实现城乡融合发展。

With the gradual construction of the“dual circulation”development pattern,promoting the two-way opening of urban and rural areas and allowing the free flow of resource elements between urban and rural areas are the key measures to realize the integration of urban and rural areas.Based on the quasi-natural experiment of Integrated Medical Insurance System(IMIS),empirically verifies the effect of improvement of benefit portability on rural-urban migrants’settlement intention by employing the data set of China Labor Force Dynamic Survey(CLDS)with DID method and PSMDID method.The results illustrate that:The IMIS significantly inhibits rural migrants’settlement intention,especially for those who are cross-city migrants,with the transition of the integration model from“single system,multi-standard”to“single system,single-standard”,this negative impact is gradually weakened.It means that since the strategy of rural vitalization,the value of rural household registration has significantly increased,migrants are enthusiastic about returning home,and the role of IMIS is more reflected in promoting the free and equal flow of urban and rural labor factors.The IMIS and its two integration models only significantly inhibits low-income migration group’s intention to settle down in urban.The settlement intention effect of IMIS on rural-urban migrants shows significant inter-generational heterogeneity,the“single system,multi-standard”model has a significant inhibitory effect on two generation of migrants’urban settlement intention,and the“single system,single-standard”model has only a negative impact on the settlement intention of the“old generation”migrants.As a result,the equalization of public service represented by IMIS in China urgently needs to be systematically reformed to gradually improve the benefit portability of health insurance among different regions,and in order to realize labor factor free mobility,ultimately improve inclusive development between rural and urban areas.