Migrant workers with and without legal status often remain excluded from national health schemes. The proposed paper investigates rationales and implications of states'' health policies towards migrant workers, including the politics of developing health indicators for migrants populations. Germany and Israel serve as test cases due to the following common features a) large migrant worker populations, b) immigration and citizenship regimes based on exclusionary conceptualizations of national belonging, and c) a commitment to universal health coverage. However, while in Israel health entitlements are dependent on permanent legal residency, Germany applies an employment-based insurance scheme that is theoretically independent of legal status. Methodology includes analysis of key policy documents and in-depth interviews with key-informants in Germany and Israel, and analysis of socio-demographic and health-related data retrieved from NGOs that serve as the main healthcare providers for uninsured persons in Berlin and Tel Aviv. Health policies towards migrant workers reflect tensions between different rationales, such as the logic of the citizen and immigration regimes, the logic of public health, of cost-containment and of human rights. While these tensions entail inconsistencies and paradoxes in health policies and actual healthcare delivery to migrant workers, patterns of disease and healthcare-seeking among migrant workers reflect inequalities in terms of underlying determinants of health, health risks, and access to healthcare. We recommend to take the rationales of public health ethics, human rights and health economics stronger into account when determining health policies for migrant workers and to reconsider the integration of migrant healthcare into existing healthcare structures.
