Uninsured migrants: Health insurance coverage and access to care among Mexican return migrants

Background: Despite an expansive body of research on health and access to medical care among Mexican immigrants in the United States, research on return migrants focuses primarily on their labor market mobility and contributions to local development. Objective: Motivated by recent scholarship that documents poor mental and physical health among Mexican return migrants, this study investigates return migrants' health insurance coverage and access to medical care. Methods: I use descriptive and multivariate techniques to analyze data from the 2009 and 2014 rounds of Mexico's National Survey of Demographic Dynamics (ENADID, combined n=632,678). Results: Analyses reveal a large and persistent gap between recent return migrants and non-migrants, despite rising overall health coverage in Mexico. Multivariate analyses suggest that unemployment among recent arrivals contributes to their lack of insurance. Relative to non-migrants, recently returned migrants rely disproportionately on private clinics, pharmacies, self-medication, or have no regular source of care. Mediation analysis suggests that returnees' high rate of uninsurance contributes to their inadequate access to care. Conclusion: This study reveals limited access to medical care among the growing population of Mexican return migrants, highlighting the need for targeted policies to facilitate successful reintegration and ensure access to vital resources such as health care