We evaluate aspects of Mexico’s Seguro Popular program, one of the world’s largest health policy reforms of the last two decades. The reform is designed to provide health insurance for the half of the Mexican population without it, as well as regular and preventive medical care, pharmaceuticals, and improved health facilities. Our evaluation is also large scale: although it only covers ten months, it constitutes what may be the largest randomized health policy experiment to date in any country. We find, unlike the vast majority of claimed attempts to deliver services to the poor in the developing world, that substantial resources spent by Seguro Popular actually did make it to the poor: catastrophic and other out-of-pocket expenditures for inpatient and outpatient medical procedures were drastically reduced by the program. On the other hand, our analysis shows, contrary to expectations of program officials, that Seguro Popular applied over our evaluation period caused no reduction in expenditures on medication and no increase in the utilization of medical care. Future rounds of experimental followup at longer intervals may allow us to reveal these effects and will therefore need to take place, as planned, to ascertain whether the program becomes as beneficial for the health of the Mexican people as it has been for aspects of their finances.

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