Educational Disparities in Access to Health Insurance in China, 1989–2009

Using data from the China Health and Nutrition Survey, we examine changes in educational differentials in access to health insurance over the period 1989–2009. Our analysis yielded three notable results. Firstly, regardless of level of education, the overall health insurance access rate exhibited a U-shaped change during the study period and the majority of people have been covered by health insurance by 2009. Secondly, the better educated enjoyed the advantage in receiving health insurance, particularly for employment-based insurance. Thirdly, educational disparity in access to health insurance changed over time. Specifically, the influence of education on overall access to insurance has been in decline during the two decades studied, indicating a convergence of access to health insurance across education levels. In contrast, employment-based insurance has converged across education level in the earlier years but diverged in more recent years over our study period. We argue that these patterns should be understood in the context of market reforms and changes of state-welfare provision over time.