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Healthcare coverage for undocumented migrants in Spain: Regional differences after Royal Decree Law 16/2012

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  • Cimas, Marta
  • Gullon, Pedro
  • Aguilera, Eva
  • Meyer, Stefan
  • Freire, José Manuel
  • Perez-Gomez, Beatriz

Abstract

The economic crisis has prompted the debate on how to regulate health coverage of undocumented migrants in publicly funded healthcare systems. Spain, as one of the most heavily affected countries in Europe, can be considered a case of particular interest. In 2012 the Spanish Government issued a Royal Decree Law (RDL 16/2012) which revoked their previous full right to public healthcare coverage, now limited for some exceptions. However, the Spanish National Health System is highly decentralized, and this Central Government decree had to be implemented by the Regional Health Authorities. Our aim is to compare regional policies regarding entitlement to healthcare for undocumented migrants after RDL 16/2012 in the 17 Autonomous Regions by performing an exhaustive review of the regional health policy regulations published after the enactment of RDL 16/2012. Our analysis shows that many Regions adopted legal, legislative and administrative actions to void or limit its effects, while others applied it as intended, resulting in huge differences in healthcare coverage for irregular migrants among Spanish Regions. The unequal implementation of this Law constitutes a paradigmatic example of the complexity of nation-wide regulation of controversial key issues in decentralized health systems. In addition, our results highlight that within-country differences in access and/or entitlement can be as relevant as those reported among-country when there is healthcare decentralization.

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  • Cimas, Marta & Gullon, Pedro & Aguilera, Eva & Meyer, Stefan & Freire, José Manuel & Perez-Gomez, Beatriz, 2016. "Healthcare coverage for undocumented migrants in Spain: Regional differences after Royal Decree Law 16/2012," Health Policy, Elsevier, vol. 120(4), pages 384-395.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:4:p:384-395
    DOI: 10.1016/j.healthpol.2016.02.005
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    References listed on IDEAS

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    1. Vázquez, María-Luisa & Terraza-Núñez, Rebeca & Vargas, Ingrid & Rodríguez, Dolors & Lizana, Tona, 2011. "Health policies for migrant populations in three European countries: England; Italy and Spain," Health Policy, Elsevier, vol. 101(1), pages 70-78, June.
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    3. Alonso, José M. & Clifton, Judith & Díaz-Fuentes, Daniel, 2015. "The impact of New Public Management on efficiency: An analysis of Madrid's hospitals," Health Policy, Elsevier, vol. 119(3), pages 333-340.
    4. Mladovsky, Philipa, 2009. "A framework for analysing migrant health policies in Europe," Health Policy, Elsevier, vol. 93(1), pages 55-63, November.
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    Cited by:

    1. Harald Bauder & Dayana A. Gonzalez, 2018. "Municipal Responses to ‘Illegality’: Urban Sanctuary across National Contexts," Social Inclusion, Cogitatio Press, vol. 6(1), pages 124-134.
    2. Caoimhe Rice & Judit Vall Castelló, 2018. "Hit where it hurts – healthcare access and intimate partner violence," Working Papers 2018/22, Institut d'Economia de Barcelona (IEB).
    3. Cristina Borra & Jerònia Pons-Pons & Margarita Vilar-Rodríguez, 2020. "Austerity, healthcare provision, and health outcomes in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 409-423, April.
    4. Porthé, Victoria & Vargas, Ingrid & Sanz-Barbero, Belén & Plaza-Espuña, Isabel & Bosch, Lola & Vázquez, Maria Luisa, 2016. "Changes in access to health care for immigrants in Catalonia during the economic crisis: Opinions of health professionals and immigrant users," Health Policy, Elsevier, vol. 120(11), pages 1293-1303.
    5. Bellés Obrero, Cristina & Rice, Caoimhe T. & Castello, Judit Vall, 2023. "Hit Where It Hurts: Healthcare Access and Intimate Partner Violence," IZA Discussion Papers 15994, Institute of Labor Economics (IZA).
    6. Peralta-Gallego, Leia & Gené-Badia, Joan & Gallo, Pedro, 2018. "Effects of undocumented immigrants exclusion from health care coverage in Spain," Health Policy, Elsevier, vol. 122(11), pages 1155-1160.

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