US-Mexico cross-border health visitors: how Mexican border cities in the state of Baja California address unmet healthcare needs from US residents

Millions of uninsured and underinsured individuals in the United States (US) face considerable barriers to care access. To address some of them, many cross the southern border with Mexico to utilise lower-cost healthcare. This paper uses 2010 and 2013 data from international travellers into Baja California (Mexico) to examine how Mexican border cities address the unmet healthcare needs from US residents. I argue that changes in health insurance entitlements under the ACA are unlikely to change the incentives to make use of health services south of the border. This study shows that healthcare supply in Mexico sometimes complements and others substitutes healthcare available to medical travellers in the US, since healthcare rendered in Mexico is rarely covered in the US or it is less expensive and of better quality from the patient perspective. Healthcare supply in Baja California for cross-border patients focuses on services that are rarely covered by US health insurance plans, such as dental services or long-term care. We conclude that affordability, cultural familiarity, perceived quality of care in Mexico, and geographic proximity, regardless of insurance coverage in the US, continue to be comparative advantages for healthcare providers in Mexican border cities.