Generous Health Insurance at 70: Effects on Enrollment, Retention, and Healthcare Utilization

In 2019, Nepal introduced a policy providing free health insurance with an enhanced benefit package (NPR 100,000 coverage) to individuals aged 70 and above. Exploiting the sharp age discontinuity at 70, I employ a regression discontinuity design to estimate the causal effects of this generous health insurance provision on initial enrollment, re-enrollment rates, and healthcare utilization. The analysis leverages novel individual-level administrative data linking insurance claims and registration records from Nepal’s National Health Insurance Program, offering insights into the impacts of targeted health insurance subsidies for elderly populations in a lower-middle-income country context.