Abstract
Access to health care and financial protection for migrants can be promoted through diverse health insurance schemes, designed to suit migrants' needs within a specific context. The Migrant Fund (M-Fund) is a voluntary, non-profit health insurance scheme operating along the Thai-Myanmar border in Thailand since 2017 and aims to protect the health of migrants uncovered by existing government insurance schemes. A qualitative evaluation was conducted between December 2018 and March 2019 to determine M-Fund's operational impacts, provide recommendations for improvement, and draw suggestions about its role in protecting migrant health. In-depth interviews with 20 individuals and 5 groups were conducted in three categories: (1) International, national, and local partners; (2) M-Fund clients; and (3) M-Fund staff. Interview information was triangulated with findings from other informants, a document review, and researchers' observations. Despite covering a small number of 9131 migrants, the M-Fund has contributed to improving access to care for migrants, raised awareness about migrant health protection, and reduced the financial burden for public hospitals. The M-Fund acts as a safety-net initiative for those left behind due to unclear government policy to protect the health of undocumented/illegal migrants. Despite clear merits, the issue of adverse selection to the scheme is a critical challenge. Evidence from this evaluation is useful to inform the future design of government insurance schemes for migrants.