UTEP-Led Study Finds Mexico’s Health Reform Left Older Adults More Vulnerable to Medical Costs
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UTEP-Led Study Finds Mexico’s Health Reform Left Older Adults More Vulnerable to Medical Costs
Share of older adults with no health insurance nearly tripled while out-of-pocket spending on medications remained high
EL PASO, Texas (July 15, 2026) – Millions of older adults in Mexico lost health coverage in the wake of a sweeping national reform, leaving one of the country’s most vulnerable populations to shoulder heavy medical costs on their own, according to a new study led by The University of Texas at El Paso. The financial strain fell hardest where older adults can least absorb it: the ongoing cost of medicines needed to manage chronic disease
José Eduardo Cabrero Castro, Ph.D. (right), assistant professor of research in the Department of Public Health Sciences in the College of Health Sciences, led a study that found the share of older adults in Mexico with no health insurance nearly tripled in the wake of a sweeping national reform in 2020, while out-of-pocket spending on medications remained high. The research was published in the journal Health Policy and Planning. Credit: José Eduardo Cabrero Castro.
The research, published in the journal Health Policy and Planning, examines Mexico’s 2020 decision to replace its Seguro Popular insurance program with the Instituto de Salud para el Bienestar, known as INSABI, both of which served people who lack access to employment-based social security. The study is the first longitudinal analysis of out-of-pocket health spending among middle-aged and older Mexicans across the transition, and was led by José Eduardo Cabrero Castro, Ph.D., assistant professor of research in UTEP’s Department of Public Health Sciences.
“This is a group that faces a double burden,” Cabrero Castro explained. “They have higher healthcare needs due to chronic conditions and multimorbidity, and limited or informal income in later life.”
The research team analyzed data from nearly 14,000 adults aged 50 and older who participated in the Mexican Health and Aging Study in 2018 and 2021. Over that period, the share of older adults reporting no health insurance nearly tripled, from 9.5% to 27.2%, while affiliation with Seguro Popular and its successor fell from 30.1% to 10.9%. Additionally, neither program significantly reduced spending on medications, the single largest driver of financial burden for older Mexicans
“For an older adult managing diabetes, hypertension or multiple chronic conditions on a fixed income, the pharmacy bill is often where health policy becomes personal,” Cabrero Castro said. “Our findings show that expanding coverage on paper is not enough. When medicines are unavailable in public facilities, older <a href="https://healthylife7.com/weight-loss-drugs-could-help-treat-patients-with-eating-disorders/” title=”Weight loss drugs could help treat patients with eating disorders”>patients end up paying out of pocket at private pharmacies, and that is exactly the kind of financial shock these reforms were meant to prevent.”
The findings arrive at a pivotal moment, Cabrero Castro explained. Mexico dissolved INSABI in 2023 and is now implementing IMSS-Bienestar, its latest effort to provide care for people outside the formal workforce. The study provides a baseline for judging that reform and a practical roadmap for its success: securing pharmaceutical supply chains, pooling drug purchasing across insurance schemes, clarifying patient entitlements and moving toward coverage that does not depend on formal employment. The authors note these lessons apply broadly across Latin America and other rapidly aging middle-income regions.
Researchers from the University of Southern California, the University of Miami, UCLA and the Tecnológico de Monterrey also contributed to the study
Last Updated on July 15, 2026 at 12:00 AM | Originally published July 15, 2026
By MC Staff UTEP Marketing and Communications
