The Incorporation of Nicaraguan Temporary Migrants into Costa Rica\u27s Healthcare System: an Opportunity for Social Equity?

This dissertation explores the incorporation of Nicaraguan migrants employed temporarily under the Costa Rica - Nicaraguan Bi-national Agreement (BNA) into the Costa Rican healthcare system. Its draws on insights from the literature on citizenship and migration, particularly Linda Bosniak\u27s notion of alienage and Lydia Morris\u27 concept of `civic stratification.\u27 Exploring the social construction of alienage for different categories of migrants in three institutional domains (namely, the migration law, social security protections, and the healthcare provisions), the analysis presented in the dissertation reveals complexities depending on both the type of migrants and the institution in question. Non-citizens, such as legally employed temporary workers are granted some membership entitlements in each of these institutional domains; yet, they are excluded from others. Overall, this partial membership tends to reproduce vulnerabilities and dynamics of exclusion. Furthermore, even though legally employed temporary workers in host societies are granted certain benefits, at times policy makers and service providers tend to ignore the differences between these migrant workers and other migratory categories (such as `illegal\u27 migrants) and consequently deny benefits to all migrants regardless of their status . This dissertation makes a contribution to the literature on citizenship and migration by illustrating how policy making, particularly with respect to certain categories of migrants, is a `messy\u27 process, based on incomplete knowledge, mistaken perceptions, and unclear assumptions. The analysis reveals how the extension of benefits granted to these aliens is based on a precarious migratory status configured around their market price and a non-permanent affiliation to the host society. As a result, they are slipping through a crack between old public healthcare arrangements designed to protect national citizens, and the promotion of flexible practices for employers requiring a foreign workforce. Beyond the official government rhetoric, the BNA reaffirms traditional notions of citizenship, based on national membership not suited to protect temporary migrants. As a result, migrants get only partial coverage under the public social security and healthcare systems. In addition, the special needs of these migrants are largely ignored. These exclusions leave legal temporary migrant workers unprotected and vulnerable