The rapidly aging Mexican-born population in the United States presents challenges for policy-makers in both this country and Mexico. Using a nationally representative data set of elderly Mexicans (sample size 3,007), the authors of this article explore the relationship between U.S. migration and health insurance coverage for Mexicans of retirement age (65 and over). They find that Mexicans who return to Mexico often have difficulty obtaining health insurance, due in part to the fragmented Mexican social security system. In addition, health care access for elderly Mexicans is largely governed by the Mexican social security system, IMSS, which requires that workers must be aged 65 and over and have made contributions over 15 years to be eligible for retirement health benefits. For nonagricultural workers every additional year of work in the U.S. reduces the probability of health insurance coverage as an elderly person in Mexico. The probability of coverage is not lessened, however, for agricultural workers, since they are unlikely to be insured at home. For Mexicans who have contributed to the U.S. Social Security system while working in the U.S., retirement in Mexico forces them to forgo Medicare benefits for which they have paid.
Coordination between the United States and Mexico on policy options to insure Mexican migrants may prove beneficial to the social security systems in both countries as well as migrants themselves. Future research should explore the fiscal impact for the U.S. and for Mexico of establishing Medicare portability for all immigrant retirees. In addition, researchers should explore the dynamic effects of old age support on patterns of return migration.