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Shifting the safety net: Does social health insurance reshape intergenerational support?

Si Shi et al.

China Economic Quarterly International2026https://doi.org/10.1016/j.ceqi.2026.02.001article
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0.50

What the paper says

This study investigates the impact of China's Urban-Rural Resident Basic Medical Insurance (URRBMI) integration on intergenerational economic transfers within rural families. Exploiting its staggered rollout as a quasi-natural experiment, we employ a difference-in-differences design with the China Health and Retirement Longitudinal Study. Results show that the integration policy significantly increases downward transfers from parents to children, particularly among married, healthier parents with fewer children and no grandchild-care responsibilities in eastern and central regions. Conversely, we find no significant effect on upward transfers from children to parents. Mechanism analyses suggest that the policy enhances parents' willingness and capacity to support children by alleviating medical expenses and uncertainty about future health costs, rather than increasing labor participation. Overall, URRBMI integration shifts private family risk-sharing toward children without reducing upward transfers. The concentration of benefits among relatively advantaged parents indicates uneven distributional effects and limited protection for more vulnerable rural elders. • We estimate the impact of URRBMI integration on intergenerational transfers. • URRBMI significantly increases downward transfers from parents to children. • Effects are stronger for married, healthier parents with fewer children and no grandchild care. • The policy works by alleviating medical expenses and reducing future uncertainty. • Benefits concentrate among advantaged elders, revealing unequal rural protection.

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https://doi.org/https://doi.org/10.1016/j.ceqi.2026.02.001

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@article{si2026,
  title        = {{Shifting the safety net: Does social health insurance reshape intergenerational support?}},
  author       = {Si Shi et al.},
  journal      = {China Economic Quarterly International},
  year         = {2026},
  doi          = {https://doi.org/https://doi.org/10.1016/j.ceqi.2026.02.001},
}

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Shifting the safety net: Does social health insurance reshape intergenerational support?

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Evidence weight

0.50

Balanced mode · F 0.40 / M 0.15 / V 0.05 / R 0.40

F · citation impact0.50 × 0.4 = 0.20
M · momentum0.50 × 0.15 = 0.07
V · venue signal0.50 × 0.05 = 0.03
R · text relevance †0.50 × 0.4 = 0.20

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