The aim of the paper is to predict demographic changes at the regional level, based on the variation of the parameters of the healthcare system presumed to be a significant factor in both the number of population and its qualitative characteristics. It is assumed that a reform of the healthcare system reflects the institutional nature of state regulation and serves functionally as an exogenous shock in the model. Based on the agent-based modeling a model consisting of two regions has been developed. It takes into account the migration of agents making decisions based on the level of private income. Various scenarios for modeling demographic indicators are presented, depending on the selected quality regime of the healthcare system that reflects the institutional features of the region. The model is calculated based on the statistics for the Perm Region and the Sverdlovsk Region for the period 2012—2019. The approbation of the model on actual regional data confirmed its operability and adequacy. Shocks in the healthcare system are associated with the corresponding budget expenditures under budget constraints of the regional government sector and have an impact on the dynamics of migration at regional labor markets, as well as on the simulated health indicators. The simulation results confirm the effectiveness of the presented methodological approach, which can be used in the development of regional strategies, as well as planning and assessing the consequences of state reforms in social policy.