Portugal Moves to Restrict Free Healthcare for Non-Resident Foreigners
The Portuguese Government has presented a proposal to tighten the conditions for free access to the public healthcare system for foreign nationals who are not legally resident in the country. Under the initiative, people in an irregular immigration situation or unable to prove legal residence would generally have to cover the cost of their medical treatment or demonstrate that they have another form of healthcare coverage.
The proposal was registered in the Assembly of the Republic by the Social Democratic Party (PSD), led by Prime Minister Luís Montenegro, together with its governing partner, the CDS-PP. Both parties are seeking to amend the Basic Health Law to clarify which foreign nationals can benefit from the National Health Service (SNS) under the same conditions as residents.
The proposal would maintain access to public healthcare for foreigners with legal residence in Portugal. For those who do not meet this requirement, however, healthcare would generally no longer be free of charge. Patients would either have to pay for the treatment themselves or provide evidence of insurance, an international agreement or another entity responsible for covering the costs.
The reform includes an exception for cases involving a medical emergency or a risk to the patient’s life. In such circumstances, the SNS would continue to provide treatment regardless of the patient’s immigration status. Once the emergency had been dealt with, authorities could request the necessary documentation to determine who should bear the cost of the care provided.
The bill also seeks to strengthen mechanisms for identifying the party financially responsible for each treatment and facilitating subsequent payment collection. Among the measures under consideration are financial guarantees and advance payments in certain circumstances.
The Government’s argument
The PSD and CDS-PP are justifying the reform with figures from the Inspectorate-General of Health Activities. According to data cited by the parties behind the proposal, around 330,000 non-resident foreigners were treated in Portuguese hospital emergency departments between 2021 and September 2024.
Of these, more than 140,000 reportedly had neither health insurance nor international agreements covering the costs of their treatment.
The sponsors of the reform also argue that the number of foreign nationals travelling to Portugal to receive treatment through the public healthcare system has increased, particularly among people from countries outside the European Union. They cite this trend as one of the reasons for changing the current rules governing access to the SNS.
Opposition criticism
The proposal has already drawn criticism from opposition parties. The Portuguese Communist Party (PCP) rejected the initiative and accused the Government of focusing on foreigners instead of addressing what it considers structural problems within the SNS, including a shortage of healthcare professionals and insufficient investment.
This is not the first time that the PSD and CDS-PP have sought to introduce a reform of this kind. A similar proposal advanced through an initial parliamentary vote during the previous legislature with the support of Chega, but its progress was halted following the calling of early elections.
The new bill, registered on September 25, revives much of that previous proposal while introducing some changes. Its presentation comes amid a growing political debate over immigration in Portugal, following a significant increase in the country’s foreign-born and foreign-resident population.
