城乡居民医保整合对农村家庭的减贫长效作用

Long-term effect of urban-rural residents'health insurance integration on rural households in terms of poverty reduction

在乡村振兴战略背景下,为实现脱贫攻坚成果与乡村振兴的有效衔接,基本医疗保险需要发挥长效减贫作用,推动脱贫地区生态文明和经济可持续发展。本文利用中国家庭追踪调查(CFPS)数据2012—2020年的农村家庭数据,运用多期双重差分(DID)及双重差分倾向得分匹配方法(PSM-DID),检验了作为基本公共服务的城乡居民医保整合政策带来的防贫绩效,进而研究政策对农村家庭的减贫长效作用。结果显示:实施城乡居民医保整合政策能够显著降低农村家庭贫困脆弱性,也发挥了良好的长效减贫作用;通过异质性分析发现城乡居民医保整合政策对低收入及中等收入人群、贫困脆弱程度较高、无老人家庭、无住院成员家庭及生态脆弱地区家庭更能有效发挥其减贫效应;机制检验表明城乡居民医保整合可以通过增加农村家庭资本积累、降低医疗保健支出、提升健康水平以及提升主观社会地位发挥减贫长效作用。

In the context of the rural revitalization strategy,in order to achieve an effective connection between poverty alleviation achievements and rural revitalization,basic medical insurance needs to play a long-term role in poverty reduction and promote the sustainable development of ecological civilization and the economy in poverty-stricken areas.This paper uses rural household data from the China Family Panel Studies(CFPS)from 2012 to 2020,and employs multi-period Difference-in-Differences(DID)and Propensity Score Matching-Differencein-Differences(PSM-DID)methods to examine the poverty prevention performance brought by the integration policy of urban and rural residents'medical insurance as a basic public service,and further studies the long-term effect of the policy on poverty reduction in rural families.The results show that the implementation of the integration policy of urban and rural residents'medical insurance can significantly reduce the vulnerability to poverty of rural families and also play a good long-term role in poverty reduction.Through heterogeneity analysis,it is found that the integration policy is more effective in reducing poverty among low-and middle-income groups,families with high vulnerability to poverty,families without elderly members,families without hospitalized members,and families in ecologically fragile areas.Mechanism tests show that the integration of urban and rural residents'medical insurance can play a long-term role in poverty reduction by increasing rural household capital accumulation,reducing healthcare expenditures,improving health status,and enhancing subjective social status.