The Mexican diaspora in the US continues to face significant barriers accessing and utilizing healthcare. Uninsured or underinsured Mexican-Americans often travel across the border to Mexico to utilize healthcare south of the border due to financial, cultural, and personal factors. Policymakers in the US and Mexico have been developing policies and programmes to offer health insurance coverage in the US and Mexico to the increasing number of Mexican-Americans who utilize healthcare in the two countries, and to Mexican families that depend on the income from US migrant workers. The implementation of ambitious healthcare reforms in the US in 2014 and in Mexico in 2012 will expand health coverage to previously uninsured families in the two countries, potentially altering the patterns of US-Mexico transnational healthcare utilization. This chapter analyses the possible impact of healthcare reform in the two countries and discusses how these policy approaches could impact the current flow of transnational healthcare patients between the US and Mexico using three policy scenarios. This chapter also discusses the political and legal implications that would need to be addressed to implement large-scale bi-national health insurance coverage for transnational Mexican-American populations between the US and Mexico.