Improving Access to Health Care for Undocumented Immigrants in the United States (Salud Pública de México)

Mexican immigrants, especially those who are undocumented, are among the least likely to have health insurance of any population. So they should enthusiastically support policies that expand coverage, right? Wrong, according to this article in the journal Salud Pública de México. In the study, Center Associate Director Steven Wallace and co-authors discuss the findings from four focus groups held with uninsured and mostly undocumented Mexican immigrants. The participants discussed three coverage expansion approaches most often discussed in policy circles: binational health insurance, expanded job-based insurance as well as expanded community health centers.

Of the three, only an expanded network of community health centers had broad appeal. Why? Immigrants worried that binational health insurance, in which patients can access less-costly services on the Mexican side of the border, would compel the undocumented to make a difficult and risky border crossing. And few focus group participants felt that expanded job-based coverage would help them, as they worked for multiple employers, were part-time workers, or worked for cash and would therefore not qualify as a "full-time" employee of a business. Expanding the capabilities of community clinics, which are already trusted sources of care for many, was the favored option, but clinics would still be limited in their ability to provide specialty and hospital care.

• Steven P. Wallace, PhD
• Michael Rodri­guez, MD, MPH
• D. Imelda Padilla-Frausto, PhD, MPH
• et al