I’ve never considered leaving the US to drive to Canada for a physician visit, or a trip to the dentist. But making such international crossings are something many in the South Texas border region do on a regular basis. This aspect of the region was not something that I had really considered much before beginning to talk to residents of these communities. I understood that the economies of border towns and their sister cities on the other side were deeply intertwined, yet it never crossed my mind that this would apply to health care as well.
The reasons that people choose to cross the border to receive care are multiple: lower costs, culturally compatible providers, familiarity with certain clinics, among others. Many of those who cross are very happy with the care they receive in Mexico and may in fact prefer to seek care there over the US because of familiarity with providers there.
Utilizing Mexico for care has, in effect, helped to shelter some uninsured people of the Rio Grande Valley from the negative health effects suffered by many uninsured in the US. At the same time this type of health care utilization may result in delaying care while a person finds the opportunity to make the trip to Mexico, while balancing work, school, and other commitments. For the time being, it seems that some uninsured people are choosing to simply forgo enrolling in health insurance and are willing to simply pay the fine.
The added dimension of a fluid border creates an additional wrinkle to effectively implementing the Affordable Care Act in the Rio Grande Valley and other US-Mexico border regions. I anticipate that when fines continue to increase that seeking care across the border will have less of an impact on enrollment rates. However, for now it is apparent that many are happy to continue crossing to fulfill their health care needs.