# Insurance Expansion During Pregnancy

## TL;DR

Removing cost-sharing in health insurance for pregnant women in Switzerland slightly increased healthcare spending, especially for low-income individuals, with some benefits for newborn health.

## Contribution

The study provides novel evidence on how cost-sharing removal affects healthcare demand and outcomes during pregnancy, particularly among low-income groups.

## Key findings

- Abolishing cost-sharing slightly increased average gross healthcare spending during pregnancy.
- Physiotherapy and lab service use rose by up to 50% among low-income individuals.
- Newborn health improved for low-income groups, but maternal health was unaffected.

## Abstract

We analyze how the abolition of cost‐sharing in health insurance affects pregnant women's gross spending on health care services using an exogenous policy change in Switzerland. Using non‐linear regression, we find that the policy slightly increases average gross spending, contrasting policymaker expectations of no impact on demand. More importantly, however, we find strong demand responses for specific types of services (physiotherapy, laboratory services), in particular for below‐median income individuals. Within this group, we find that physiotherapy increases as much as 50% in response to the policy change. Additionally, we find suggestive evidence of a relative improvement of newborn health among individuals with below‐median income, indicating that additional use of healthcare services may be beneficial. However, we find no evidence of an impact on maternal health. These results highlight that cost‐sharing policies—such as the one we examine—need to balance trade‐offs between reducing healthcare costs and addressing the health and equity implications of such policies.