A Welfare Magnet in the South? : Migration and Social Policy in Costa Rica

The incorporation of Nicaraguan migrants in Costa Rica’s welfare arrangements is polemic, especially because the country’s ‘exceptional’ social policy regime and its flagship healthcare institution are under (financial) pressure, and the principle of universalism is in erosion. In this context, this research analyses the ways in which migration and social policy interact, and migrants’ access to social services, specifically healthcare. It constitutes an important empirical contribution to a public policy debate in the country centred around the idea that Costa Rican health services constitute a welfare magnet for Nicaraguan migration, through which the legitimacy of their claim to health services is questioned. It is argued, however, that there is little empirical foundation for this idea.
At the same time, it speaks to larger debates on social exclusion and universalism. It discusses institutional processes of exclusion, in the form of restrictive state reactions to migrant inclusion in the context of the social security crisis. Despite acknowledgement of human rights frameworks, the state finds inventive ways to circumvent these and restricts migrants’ access to healthcare by giving a central role to healthcare institutions in (internal) migration management. This research then argues that such state reactions correlate to negative perceptions of migration, migrant incidence and the legitimacy of migrant healthcare demands of officials of crucial institutions for migrant inclusion. However, such perceptions are not backed by empirical data.
Finally, the research strongly argues the need to go beyond the recognition of formal social rights and look at the extent and ways in which migrants actually access social services. Based on focus group discussion with migrants and primary survey data, this document contains an elaborate discussion of the factors that determine mi-grants’ access to public health insurance, health services and medicine. The findings suggest that regularization is a necessary, but insufficient, condition for social integration, thereby questioning the state’s limited understanding of integration, which focuses exclusively on the regularization of ‘illegal’ migrants. More importantly, however, it shows that universalism in social policy does not apply equally to nationals and migrants, and is in fact, stratified.