Expanding access to health insurance in low- and middle-income countries is a policy priority, but evidence on its effects remains limited. This paper provides new and timely evidence on the effects of government-led health insurance program in Nepal, a country uniquely suited given the program’s staggered rollout across districts over time. Using novel and rich administrative health data from 2014-2022, I examine program’s impacts on health care utilization, health outcomes and access to higher quality health care. To ensure a clean identification, I exploit a natural experiment created by a staggered rollout. The differences in differences design compares districts that have introduced the insurance program with districts that have yet to do so. I employ the Callaway and Sant’Anna (2021) estimator to address the potential biases from treatment effect heterogeneity, and as long as the parallel trends hold between these two groups, I can isolate the causal effect of health insurance.