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A key facet of the Patient Protection and Affordable Care Act (PPACA) is the expansion of health insurance coverage. However, even with the PPACA, an estimated 11.2 million undocumented immigrants will remain uncovered. The majority of the remaining uncovered immigrant population is of Mexican origin. We assess the long-term benefits and short-term costs of providing coverage to male migrants from Mexico, employing data from the 2007–2011 Mexican Migration Project (MMP) and the 2009 Medical Expenditures Panel (MEPS) survey. Our results show that health status prior to migration, age at time of interview, emigrating from Central Mexico, and use of health services in the U.S. all predict declines in health at a significant level. We also find that having spent more than 10 cumulative years in the U.S. has borderline significance in predicting health decline (p=.052). Estimated coverage costs for health insurance for largely undocumented immigrants increase over time, but remain lower than those of comparable U.S.-born individuals. We conclude with several policy implications.