Overview
- Twenty-three states have signed agreements ceding infrastructure, staff and portions of FASSA as IMSS-Bienestar takes over operations for the uninsured.
- The 2024 withholding cut FASSA flows 23% overall, averaging a 34% drop—about 38 billion pesos—in participating states, with a further 20% reduction projected for 2025 versus 5% in nonparticipants.
- State health secretariats in participating states cut spending 13% in 2024 and plan another 12% in 2025, reductions that fall short of lost transfers due to rigid operating costs.
- FASSA is covering a smaller share of health outlays in adherent states, sliding from 47% in 2023 to a projected 35% in 2025, compared with roughly 41–43% in states outside the program.
- Moody’s estimates the added gap at about 0.7% of operating income by end-2025 and flags credit risk for the hardest-hit jurisdictions, including Puebla, Mexico City, Nayarit, Tabasco and Chiapas, with steep 2025 pressures also in Baja California, Hidalgo and the State of Mexico.