The two parties that support Portugal’s minority Government have tabled a bill requiring foreigners in the country illegally, and non-residents, to pay for treatment under the national health service or prove they are covered.
The Social Democratic Party (PSD) and the CDS – People’s Party (CDS-PP) registered the text in the Assembly of the Republic on September 25. It would amend the 2019 health framework law that sets out who qualifies for the Serviço Nacional de Saúde (SNS).
Portuguese citizens and foreigners legally resident or temporarily staying in the country would remain beneficiaries. That covers nationals of European Union member states, third-country nationals, stateless people and applicants for international protection.
Those in an irregular situation or not resident in Portugal would instead pay for the care they received, or produce proof of cover from an insurer, an international agreement or another party legally responsible.
Emergency and life-saving treatment would still be given regardless of status, though patients would afterwards have to supply the necessary documentation. The bill would also require the law to set out how those liable are identified and costs recovered, including guarantees or advance payment.
PSD and CDS-PP base part of their case on a November 27, 2024 report by the health inspectorate IGAS. It concluded that about 330,000 foreigners not resident in Portugal were treated in SNS hospital emergency departments between 2021 and September 2024, more than 140,000 of them without insurance or an international agreement covering that care.
The two parties argue in the bill’s preamble that a growing number of third-country nationals travel to Portugal to obtain free treatment, in some cases through illegal networks. They hold the Socialist Party and the rest of the parliamentary left responsible for the current wording of the law.
The initiative is a revival. A similar text cleared a first vote in the previous parliament with the backing of Chega, the right-wing party now the largest opposition force, but lapsed when early elections were called.
Communist Party leader Paulo Raimundo rejected the plan on September 26, saying the government was diverting attention from the real problems of the SNS, the shortage of health professionals and the lack of investment. He also pointed to the 26 million tourists who visit Portugal each year.
The bill still has to be debated and voted on, so nothing changes yet. It follows a run of migration measures in a country whose foreign population has grown sharply, among them a law enacted in September that speeds up the expulsion of illegal migrants after Chega abstained.
Montenegro has also criticised what he called a lack of rules on migration flows in Europe, saying some governments pursue policies that act as a pull factor.
