MEXICO · TRADE
Key Facts
- —The country Mexico is a US neighbour and USMCA trade partner, led by President Claudia Sheinbaum.
- —Why it matters The USMCA trade pact between the US, Mexico and Canada is under review in Washington.
- —Why now A Florida congresswoman’s letter dated 22 October asks the US trade chief to press Mexico.
- —What happened Salazar calls the Cuban doctors forced labor; Sheinbaum says they earn the same pay as Mexican doctors.
- —What it means for you Investors and exporters watch whether Washington adds forced labor to USMCA talks; no US action is announced.
- —Still open Whether the US trade office replies, and whether Mexico changes how the doctors are paid.
- —Power Index Mexico ranks 2nd of 14 in The Rio Times Latin America Power Index, with 71.4 points (October 2026 edition).
Cuban doctors in Mexico became a US trade issue on Friday 23 October 2026, when Florida Republican Maria Elvira Salazar accused Mexico of breaking the USMCA trade pact. In a letter dated Thursday 22 October to US Trade Representative Jamieson Greer, she asked him to tell Mexico that its use of Cuban doctors violates the agreement and should end.
For US readers the stakes are the USMCA itself, which Washington is reviewing, and Trump said on Friday that the US is “very close” to a deal with Mexico. Salazar is one House member and her letter is a request, not a US government decision.
We covered the pact’s status in Mexico Says North America Trade Pact Lasts 10 Years and Cuba’s trafficking grade in Cuba Stays at Worst Tier 3 in US Trafficking Report. This report covers what the letter says, how Sheinbaum answered and what the US documents show.
In Plain English
- USMCA: the 2020 trade pact between the US, Mexico and Canada, called T-MEC in Mexico.
- Jamieson Greer: the US Trade Representative, who runs trade talks for Washington.
- Maria Elvira Salazar: a Republican member of the US House from Florida, who says she has warned Mexico about the doctors for years.
- Cuban medical missions: Cuba’s government sends doctors abroad under deals with other governments, and the US says Havana keeps much of their pay.
- Forced labor: work people do under threat or restriction, which the USMCA says its three members should end.
What Salazar’s Letter Says
Salazar posted the letter on X on Friday, writing that “Mexico is breaking the rules and helping Havana profit from forced labor.” She added that more than 3,000 Cuban doctors work in Mexico under a program the US State Department has classified as forced labor.
El Universal and Infobae, which both quote the letter, say it blames agreements that Mexico signed with Cuba under former president Andrés Manuel López Obrador. Salazar writes that the doctors are kept apart from their families, face travel limits and receive only a small share of their pay, “sometimes 5%.”
The letter points to Chapter 23 of the USMCA, which says the three countries should ban imports of goods made with forced labor and aim to end all forced labor. She asks Greer to tell his Mexican counterparts that the program breaks the agreement and to ask Mexico to dismantle it and free the doctors.
Salazar says Mexico could follow Brazil under Jair Bolsonaro and pay the doctors directly instead of paying Havana. She also says she told López Obrador in person about two years ago during a congressional visit to Mexico City and that Mexico refused to act.
Salazar is seeking re-election in the US midterm vote on 3 November, El Universal noted. These are her allegations, and the sources reviewed show no reply from Greer’s office.
What Sheinbaum Said on 23 October
At her regular news conference on Friday, Sheinbaum called reports that Cuban doctors earn more than Mexican doctors, or are hired through a company, “absolutely false.” “It is direct hiring, and they earn exactly the same as a Mexican doctor,” she said in Spanish, as quoted by Infobae and other Mexican outlets.
She said the Cuban doctors help in remote places where no Mexican specialists will go, and she rejected reports that they receive only 10,000 pesos a month (about US$536). She cited net pay of 36,896 pesos a month (about US$1,977) for a doctor at the Mexican social security institute IMSS after the first year.
Those figures use the Bank of Mexico rate of 18.667 pesos per dollar for 23 October. The reports of the conference do not mention Salazar or her letter, so her remarks answered the pay reports, not the letter.
Her remarks do not address the claim that Havana keeps a share of the doctors’ pay. The sources reviewed show no Mexican reply to the forced-labor charge itself.
What the US Says About Cuban Doctors in Mexico
Salazar cites the State Department’s 2025 trafficking report, and the newer 2026 edition says more. Its Cuba section says Cuba “remained on Tier 3,” the worst grade, and finds a “government policy or pattern” of forced labor in its labor export program, which includes the medical missions.
That section says Havana keeps between 50% and 95% of workers’ wages. The Mexico section of the 2026 report counts “3,650 Cuban regime-affiliated workers in Mexico,” whom it says Havana likely forced to work.
The report says Mexico has a health cooperation agreement with Cuba under which Mexico pays the Cuban government for the workers’ services. It adds that Mexican officials said the government began paying the workers a stipend in 2026, but that no new agreement changing the payment terms was reported.
The report rates Mexico Tier 2, a middle grade for governments that do not fully meet US standards but are making significant efforts. Sheinbaum’s office has not been quoted on the 3,650 figure in the sources reviewed.
What the USMCA Text Says
Article 23.3 requires each country to adopt and maintain labor rights in law and practice, including “the elimination of all forms of forced or compulsory labor.” A footnote says a failure must be “in a manner affecting trade or investment between the Parties.”
Article 23.6 says each country shall prohibit imports of goods made in whole or in part with forced labor. That article is about goods, and the chapter does not mention health services or government hiring programs by name.
The sources reviewed do not show that any panel has applied the chapter to a state hiring program like this one. How far Salazar’s reading would hold is therefore untested in what we found.
The US declined in July to renew the pact automatically, according to EFE, so it now runs on regular reviews. On 2 October USTR opened public comment on the 2027 joint review, with a deadline of 12 January 2027 and a public hearing to come.
USTR’s current tool for workers’ rights is the Rapid Response Labor Mechanism, which targets single factories. On 8 October it asked Mexico to review the GLM Components auto-parts plant in Puebla and suspended customs liquidation of its goods, which differs from a complaint about a national program.
What It Means for You
Nothing in the letter changes tariffs, which EFE says still stand at 50% on steel and aluminium and 25% on cars. For US exporters and investors in Mexico, the practical question is whether Washington adds Cuban doctors in Mexico to its list of demands before a deal.
The letter also shows how US midterm politics can reach into trade talks, since Salazar is on the ballot on 3 November. Our guides Who Holds Power in Mexico and Cuba Explained 2026 explain the two governments behind the doctors’ program.
Patients at rural public clinics are the people most directly affected if the program for Cuban doctors in Mexico changed. Sheinbaum said the doctors fill gaps where specialists will not go, and no change to their posts has been announced.
Readers who travel to Mexico or use its public clinics will see no change from the letter alone. Any change would have to come from a Mexican decision on the program or a US move in the trade talks.
What Is Not Known
Salazar’s letter was not available on her website when we checked, so its wording comes from El Universal, Infobae and El Financiero, which agree on its contents. Her post on X is quoted as embedded by El Universal.
No reply from Greer’s office or from Mexican officials to the letter itself had been reported by Saturday morning. Cuba’s government has not been quoted on the claims in the sources reviewed.
The doctor count differs by source, with more than 3,000 from Salazar and 3,650 in the State Department report, and no official Mexican total was found. The sources also do not show how much of the doctors’ pay, if any, passes through the Cuban government today.
Whether Greer will raise the issue in the talks is unknown. The next public step is the USTR hearing on the 2027 review, whose date has not been published.
Frequently Asked Questions
What did Salazar ask the US trade office to do?
She asked Greer to tell Mexico that using Cuban doctors violates the USMCA and to ask it to dismantle the program. She also suggested Mexico pay the doctors directly.
How many Cuban doctors work in Mexico?
Salazar says more than 3,000. The State Department’s 2026 trafficking report counts 3,650 Cuban regime-affiliated workers in Mexico.
What does Sheinbaum say about their pay?
She says the doctors are hired directly and earn exactly the same as Mexican doctors. She said so on 23 October, in remarks that did not mention Salazar’s letter.
Does the USMCA ban forced labor?
Article 23.3 requires each country to work to eliminate it, and Article 23.6 bars imports of goods made with it. The text does not name health services or hiring programs.
Will the US act on the letter?
No US action has been announced. The USMCA review continues, and public comments are open until 12 January 2027.
Sources: El Universal, 23 October 2026; Infobae, 23 October 2026; El Financiero, 23 October 2026; Viva la Noticia, 23 October 2026; Los Noticieristas, 23 October 2026; US State Department, 2026 Trafficking in Persons Report, Mexico; Cuba; USMCA Chapter 23 text (USTR); USTR, 2 October 2026; USTR, 8 October 2026; Aristegui Noticias (EFE), 23 October 2026; Bank of Mexico exchange rate.
This article was produced by The Rio Times’ automated newsroom system. How we use AI · Report an error · Editorial responsibility: Matthias Camenzind, Editor-in-Chief
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