This document discusses the potential for binational health insurance (BHI) to improve access to healthcare for binational populations living near the US-Mexico border. BHI could provide care options on both sides of the border, taking advantage of lower-cost, culturally competent providers. About 1.3 million uninsured Mexican immigrants living in the US could benefit from BHI. Affordable BHI plans ranging from $3,000 to $4,500 per year could be feasible. Key implementation challenges include potential opposition, necessary legislative and regulatory changes, and outreach to enroll eligible populations.