人口与经济Issue(6)：86-102,17.DOI:10.3969/j.issn.1000-4149.2025.06.007
基本医疗保险对居民生育意愿的影响及其机制分析
The Impact of Basic Medical Insurance on Residents'Fertility Intentions and Its Mechanism Analysis
摘要
Abstract
In recent years,China has faced dual challenges of accelerating population aging and continuously declining fertility rate,with the natural population growth rate turning negative,posing severe pressure on economic and social development.Against this backdrop,improving the fertility support system and enhancing social security function have become key measures to promote the construction of a fertility-friendly society.Basic medical insurance,as the most extensive social security system is of great theoretical and practical significance to study whether and how it affects residents'fertility intentions.Based on the data from the China Family Panel Studies(CFPS)in 2014,2018,and 2022,this paper employs a two-way fixed effects model to empirically examine the impact of basic medical insurance on residents'fertility intentions.The results show as follows:First,with notable group heterogeneity,basic medical insurance significantly enhances residents'fertility intentions.It has a more significant promoting effect on the fertility intentions of the female group,the elderly group,the group with rural household registration,the group with low education levels,and the group with lower income.Second,the new rural cooperative medicale care system has a very significant promoting effect on residents'fertility intentions,while urban resident medical insurance and urban employee medical insurance have no significant impact on residents'fertility intentions.Third,mechanism analysis indicates that basic medical insurance indirectly boosts fertility intentions by improving residents'subjective well-being and reducing the proportion of medical expenses.Fourth,basic medical insurance exerts a substitution effect on commercial insurance,thereby inhibiting fertility intentions.Fifth,further analysis reveals that basic medical insurance significantly promotes the intention to have additional children among residents who already have one child,especially among those with a boy,but has no significant effect on those with multiple children.This study expands the theoretical association between basic medical insurance and fertility intentions,providing a basis for constructing a fertility-friendly social security system.关键词
基本医疗保险/生育意愿/医疗支出/主观幸福感/替代效应Key words
basic medical insurance/fertility intentions/medical expenses/subjective well-being/substitution effect分类
经济学引用本文复制引用
袁培,韩震..基本医疗保险对居民生育意愿的影响及其机制分析[J].人口与经济,2025,(6):86-102,17.基金项目
国家社会科学基金一般项目"西部民族地区提升基本公共服务可及性和均衡性路径研究"(23BJL122) （23BJL122）
新疆财经大学研究生科研创新项目"基本公共服务供给对生育率的影响机制研究——基于生育意愿与生育条件视角"(XJUFE2025K007). （XJUFE2025K007）
