For decades, Mexicans living south of the border have commuted to jobs in California's San Diego and Imperial counties. But their status made them ineligible for health-care coverage either in the Mexican social security system or from a U.S.-based health maintenance organization.

But earlier this year California approved regulations allowing cross-border health coverage. Officials in other border states are watching developments in California for clues as to how such an arrangement would work in their jurisdictions.

• So far, two employer-funded health maintenance organizations (HMOs) have received approval to offer insurance plans that cover both Mexican and U.S. health-care systems -- one based in Tijuana, and the other being Blue Shield of California.

• A third venture, Blue Cross/Blue Shield de Mexico expects to offer a cross-border plan in Texas, Arizona and New Mexico later this year.

• HMOs are eyeing another potentially lucrative market: the 250,000 people who cross the border into Mexico each month in search of cheaper pharmaceuticals and procedures, as well as the 300,000 U.S. citizens living as retirees in Mexico.

The new health-coverage offerings have had at least one unexpected benefit: they have improved labor relations in industries heavily dependent on Mexican labor. To settle a strike by janitors, San Diego office-building maintenance companies agreed last month to enroll the laborers in one of the new cross-border HMOs.

Source: Joel Millman, "U.S. HMOs Cross the Mexican Border," Wall Street Journal, June 27, 2000.