Rick Perry was right on binational health insurance

(Chip Somodevilla - Getty Images)

Texas Gov. Rick Perry’s endorsement of a “binational health insurance” program with Mexico has drawn increasing attention this week. Most of it points to a 2001 plan, where Perry lauded an “an important study that will look at the feasibility of binational health insurance” that could “treat maladies unique to this region.”

“Binational health insurance” with the United States and Mexico doesn’t exactly make for a great sound bite in the Republican primaries. But the policy Perry discussed in that speech was actually a really good, conservative one that Texas would have been smart to implement.

To clarify, what Perry referenced was not a merging of Mexico and the United States’ public health systems. It was not, as Wonkette put it, “U.S.-Mexico Obamacare.” Rather, he pointed to a newly passed Texas law, which directed the state to explore allowing private health plans to cover services in Texas and Mexico. Those plans would then be available to any Mexican national or American citizen working within 62 miles of the Texas-Mexico border.

There’s a lot to like about this idea.  

First, it targets a big problem in Texas: a lack of insurance. With 26 percent of Texans lacking insurance, the state has the highest rate of uninsured people in the country. Those numbers are even higher in Texas’s border region, according to a 2003 Texas State Senate report.

Second, it’s a private market approach, that would allow insurers to meet an unfilled consumer need. A 2005 study showed that 72 percent of Mexico-born residents of the United States would be interested in a product that covered medical services in Mexico, especially if they had dependents in Mexico who could use those services.

The plan Perry referenced wouldn’t have the state create such a plan. Rather, it would alter Texas’s insurance regulations to allow private carriers to do so.

Third, the benefits could be numerous and largely economic. More access to preventive care and better management of chronic conditions, the Texas Senate report argued, could create a healthier workforce with “less absenteeism due to illness of the worker or family members.” More Texas residents with insurance would mean less uncompensated care, which cost the state’s border hospitals $600 million in 1999.

This explains why industry groups strongly backed the idea of binational plans in a series of 1997 hearings on the issue. A 2004 University of Texas report on the states’ binational health plans points meetings attended by the restaurant, hotel and construction industries, as well as labor unions and insurers. “They all argued to allow some sort of regulated cross-border insurance product,” the report recounts. “Without such a product, they claimed, these workers would be uninsured, and the resulting situation could present a burden to the state in terms of uncompensated health care costs to hospitals.”

Last, binational health plans probably would cut into reliance on public programs, particularly the Children’s Health Insurance Program, the same report concluded. “Proponents saw binational health plans as a new, affordable private health insurance that could replace the State Children’s Health Insurance Program (SCHIP),” the report says. “Savings in tax dollars would be generated with a decreased number of children on SCHIP and revenues from health care would increase (due to reduction in uncompensated care).”

Binational health plans in Texas have yet to come to fruition. The Texas law only directed a study committee and, since then, has not take action on the issue. Interestingly, much of the opposition to the plan came from Texas’s physician groups, the UT study notes. They worried that, with coverage in both countries, the binational health plans would be “draining their clientele to Mexico.”