We provide the first investigation into whether and how much genes explain having health insurance coverage or not and possible mechanisms for genetic variation. Using a twin-design that compares identical and non-identical twins from a national sample of US twins from the National Survey of Midlife Development in the United States, we find that genetic effects explain over 40% of the variation in whether a person has any health coverage versus not, and nearly 50% of the variation in whether individuals younger than 65 have private coverage versus whether they have no coverage at all. Nearly one third of the genetic variation in being uninsured versus having private coverage is explained by employment industry, self-employment status, and income, and together with education, they explain over 40% of the genetic influence. Marital status, number of children, and available measures of health status, risk preferences, and prevention effort do not appear to be important channels for genetic effects. That genes have meaningful effects on the insurance status suggests an important source of heterogeneity in insurance take up.

中文翻译：

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健康保险范围内的遗传变异。

我们提供了有关是否以及多少基因可以解释是否具有健康保险以及基因变异的可能机制的首次调查。使用双胞胎设计比较美国全国双胞胎发育状况国家调查的美国双胞胎样本中的同卵双胞胎和异卵双胞胎，我们发现，遗传效应可解释一个人是否有任何遗传变异的40％以上健康保险与否，以及65岁以下个人是否拥有私人保险与根本没有保险之间的差异将近50％。没有保险和有私人保险的遗传变异中，近三分之一是由就业行业，自营职业和收入构成的，再加上受教育程度，可以解释超过40％的遗传影响。婚姻状况，儿童人数，健康状况，风险偏好和预防措施的可用措施似乎并不是遗传效应的重要渠道。基因对保险状况具有有意义的影响，表明保险承保范围异质性的重要来源。