Using data on over 4 million hospital visits, we document striking gender disparities under a government health insurance program that entitles 46 million poor individuals to free hospital care in Rajasthan, India. Females account for only 33% of insurance claims among young children and 42% among the elderly. Differences in insurance enrollment, illness incidence, or population sex composition cannot explain these disparities. Instead, we find evidence that they are driven, in part, by households' willingness to allocate more resources to male than female health care. Reducing the cost of care-seeking increases female utilization levels but widens gender disparities, consistent with households spending their marginal rupee on males. Long-term exposure to randomly assigned female village-level political representatives helps close the gender gap. In the presence of gender bias, universal health coverage programs may increase female healthcare utilization but fail to reduce gender inequalities without actions that specifically target females.
Co-author: Radhika Jain
Professor Dupas is a development economist seeking to better understand challenges facing poor households in lower income countries. Her aim is to identify tools and policies that can help overcome these challenges and reduce global poverty.