Spain’s Council of Ministers has approved a royal decree mandating universal access to public healthcare for all foreign nationals residing in the country, even those without legal status.
The decision eliminates administrative barriers that have restricted coverage since 2012.
The measure, adopted today, obliges every autonomous community to provide full healthcare services to undocumented migrants, aiming to restore the pre-2012 model of universal healthcare and prevent territorial disparities in access.
Critics from the Right have condemned the policy as unsustainable amid pressures on public services.
Vox Party leader Santiago Abascal warned in related commentary on migration measures that such initiatives “will aggravate the collapse of healthcare, housing and our security”, arguing they create a “pull effect” for further arrivals.
The decree reverses key aspects of Real Decreto-ley 16/2012, enacted under the previous Popular Party (PP) government of then-prime minister Mariano Rajoy, which limited public health coverage primarily to those with legal residency or specific vulnerable groups.
Under the new rules, lack of municipal registration or documentation will no longer serve as an obstacle to receiving primary care, specialist treatment, or accessing hospital services.
Alternatives may be submitted in absence of traditional registration, including certificates of schooling or enrolment in public centres, social services reports, certificates of registration of visits, utility bills in the applicant’s name, consular registration cards, or other consular documents, according to a statement from the Ministry of Health.
Foreign women who want to abort their unborn child will also be able to use the decree.
The government emphasised the move was a reinforcement of the right to health as a fundamental principle, with the decree set to take immediate effect upon publication in the Official State Gazette.
Health minister Mónica García, who spearheaded the initiative, described it as a step towards “true universality” in the National Health System.
Sources close to the heath ministry indicated the change addresses longstanding inequities, particularly in regions with high migrant populations where irregular residents have faced denial of treatment or emergency-only care.
The reform aligns with the Spanish Socialist Workers’ Party-led coalition’s broader migration strategy, following January’s decree to regularise up to 500,000 undocumented migrants through a fast-track residency process starting in April.
Conservative outlets echoed concerns over fiscal strain on an already stretched system facing waiting lists and staffing shortages.
The decree comes as Spain continues to buck the trend of tightening migration controls seen elsewhere in Europe.
With applications for the earlier regularisation programme due to open soon, successful applicants will gain full access to healthcare via social security contributions but today’s measure ensures coverage even for those who do not qualify or are awaiting decisions.
Human rights organisations and migrant advocacy groups welcomed the reform as a humanitarian advance, although some noted implementation challenges remain, including co-ordination across Spain’s 17 autonomous communities and potential regional resistance.
The government has committed to monitoring compliance to avoid inequalities in application.
