Mechanisms Affecting the Participation of Migrant Populations in Basic Health Insurance:a Study of Time Accumulation,Economic Thresholds and System Barriers
Peng Boshi
Abstract：Objective:To reveal the decision-making mechanism of basic medical insurance participation for China's floating population and provide scientific basis for promoting the high-quality development of medical insurance.Methods:Based on the seven-period data of China Family Panel Studies(CFPS)2010-2022,multilevel logistic regression was used to analyze institutional,economic and time factors,Hansen threshold regression was applied to identify the threshold of contribution burden,segmented regression was applied to test the effect of length of residence,and the instrumental variable method(dialectal distance)was applied to control for endogeneity.Results:(1)Time-cumulative effect:the probability of enrollment jumped significantly when the length of residence reached 18 months(aOR increased from l.36 to 2.10);(2)economic threshold:the contribution burden of 8.06％was the sensitive threshold,and the absolute decline in enrollment rate beyond the threshold was 19.2％(P＜0.001);(3)institutional barriers:interprovincial mobility reduced the participation incidence ratio by 38％,and the reimbursement ratio difference decreased by 13％for every 10％increase in the participation incidence ratio.Conclusion:Participation decisions are subject to a triple mechanism,which requires anchoring the 18-month residence node to set gradient incentives,implementing a precise cap for the 8％burden threshold,and removing institutional barriers through provincial coordination.
Keywords：migrant populationbasic medical insuranceparticipation decisionmechanism analysis
Publication Date：2026-01-05
Online Publishing Date：2026-01-31(First online date of this platform, not the publication date of the document)
Pages：5( 39-42,50 )