WP n° 67bis

The Likely Effects of Employer-Mandated Complementary Health Insurance on Health Coverage in France
Pierre A. (Irdes, CESP Inserm), Jusot F. (Université Paris-Dauphine, PSL Research University, Leda-Legos & Irdes)
Irdes working paper n° 67bis. 2017/01

In France, access to health care greatly depends on having a Complementary Health Insurance coverage (CHI). Thus, the generalisation of CHI became a core factor in the national health strategy created by the government in 2013. The first measure has been to compulsorily extend employer-sponsored CHI to all private sector employees on January 1st, 2016 and improve its portability coverage for unemployed former employees for up to 12 months. Based on data from the 2012 Health, Health Care and Insurance survey, this article provides a simulation of the likely effects of this mandate on CHI coverage and related inequalities in the general population by age, health status, socio-economic characteristics and time and risk preferences. We show that the non-coverage rate that was estimated to be 5% in 2012 will drop to 4% following the generalisation of employer-sponsored CHI and to 3.7% after accounting for portability coverage. With its focus on private sector employees, the policy is likely to do little for populations that would benefit most from additional insurance coverage while expanding coverage for other populations that appear to place little value on CHI. Indeed, the mandate could reduce the relationship between non-coverage and time and risk preferences without eliminating social inequalities as the most vulnerable populations are expected to remain more often without CHI.