Facilitated enrollment in public health insurance: Effects on prenatal care and birth outcomes

Many countries are expanding public health insurance for the uncovered, but administrative barriers can reduce enrollments. However, lowering barriers may insure people with marginal health benefits and crowd out services to incumbents. We use novel longitudinal administrative childbirth data to examine the impact of Medical Insurance Century XXI (SMS), a children’s program that auto-enrolled family members in Mexico’s Seguro Popular (SP) health insurance. SMS increased SP coverage among pregnant women, especially those who previously delivered in private hospitals. This group increased the utilization of prenatal care, without significant changes in birth outcomes, and without negative spillover effects on incumbent women.