Public and Commercial Medical Insurance Enrollment Rates of Rural-to-Urban Migrants in China

Abstract Objectives: China’s large-scale rural-to-urban migration has provoked heated discussion about migrants’ health and whether they have equal access to health resources. This article aims to compare public and commercial medical insurance enrollment rates between temporary, permanent migrants and urban natives. Methods: Average marginal effects of weighted logistic regression models using 2017 China General Social Survey from 2,068 urban natives, 1,285 temporary migrants and 1,295 permanent migrants. Results: After controlling for demographic and socio-economic characteristics, our results show that while temporary and permanent migrants have a similar public insurance enrollment rate compared to urban natives, both temporary and permanent migrants have significantly lower commercial insurance enrollment rates (7.5% and 5.3%, respectively) compared to urban natives. Conclusions: The results highlight significant institutional barriers preventing temporary migrants from gaining access to public medical insurance and the adverse impact of disadvantaged socio-economic backgrounds on temporary migrants’ access to both public and commercial insurance.