The impact of health insurance on rural energy transition: evidence from rural China.

Introduction: Although many studies in developing countries have paid attention to the importance of rural energy transition, the significance of the healthcare system in the energy transition process has not received sufficient attention. This study investigates whether and how participation in the New Rural Cooperative Medical Scheme (NRCMS) affects rural household clean energy consumption. Methods: Using panel data from the China Family Panel Studies (CFPS) for 2018 and 2020, covering 8,427 rural households across 29 provinces, we employ fixed- effects and instrumental variable models to address potential endogeneity. Results: The results show that NRCMS participation significantly increases the probability of adopting clean energy by approximately 2.8 percentage points. Mechanism analysis indicates that the effect operates primarily through wealth effect (reducing medical burden) and the health effect, while the precautionary savings channel is not supported. The heterogeneity analysis shows that households with low expenditure pressure are more likely to be incentivized by the NRCMS to consume clean energy than those with a larger number of unmarried members. Similarly, households with a smaller share of migrant workers are more likely to increase clean energy consumption after participating in the NRCMS than those with a larger share. Furthermore, for every one unit increase in regional medical resource endowment, the promoting effect of the NRCMS participation on rural household clean energy consumption increases by 0. 016 units. Discussion: These findings provide new insights for improving the rural medical insurance system and accelerating the transformation of rural energy consumption.