This document discusses the potential for binational health insurance (BHI) to improve access to healthcare for binational populations living near the US-Mexico border. BHI could provide care options on both sides of the border, taking advantage of lower-cost, culturally competent providers. About 1.3 million uninsured Mexican immigrants living in the US could benefit from BHI. Affordable BHI plans ranging from $3,000 to $4,500 per year could be feasible. Key implementation challenges include potential opposition, necessary legislative and regulatory changes, and outreach to enroll eligible populations.

1. Improving Access In a Binational Population The Potential Role for Binational Health Insurance Tim Waidmann & Saad Ahmad The Urban Institute

9. Coverage alternatives, cost Full US-based plan New Migrant plan + IMSS New Migrant Plan + Seguro Popular Border HMO Mexi-Plan Primary & ER $12,000 $ 3,000 $ 3,000 $ 4,080 $ 1,800 Hospital cvd $ 519 $ 180 cvd cvd Out of Pocket $ 200 $ 200 $ 200 $ 200 $ 800 Remittances $ 450 $ 450 $ 225 $ 450 $ 450 Total $12,650 $ 4,169 $ 3,330 $ 4,430 $ 3,050

13. Adults, simulated coverage *Legal status imputed from other characteristics.

18. MEPS spending estimates