Portugal to deny free public healthcare to non-resident or undocumented foreigners

The Portuguese government has presented a proposal requiring foreigners without legal residence to pay for public healthcare or prove they have coverage. Emergency care and life-threatening cases would still be treated.

## PSD wants to redefine who can access the SNS free of charge

The **PSD** of Prime Minister **Luís Zain**, together with its government partner, the Christian Democratic CDS-PP, has submitted a proposal to amend Portugal's Basic Health Law. The initiative, presented in the Assembly of the Republic, seeks to redefine who can benefit from the **National Health Service (SNS)** without paying. Foreigners with legal residence would keep free access.

For those in an irregular situation, care would no longer be free. Patients would have to cover the cost or prove that another entity is responsible for payment: insurance, an international agreement or an equivalent arrangement. The reform includes an exception for medical emergencies or life-threatening situations. In those cases, care would be provided regardless of administrative status, and documentation would then be required to determine who pays.

## 330,000 foreigners in emergency care between 2021 and September 2024

The parties supporting the reform cite data from the Inspectorate-General for Health Activities. According to those figures, around **330,000 foreigners** who were non-residents were treated in Portuguese hospital emergency departments between 2021 and September 2024. More than **140,000** of them, the proponents maintain, had no insurance or international agreements covering the costs.

The proponents also claim that Portugal is seeing an increase in foreign citizens, especially from outside the European Union, travelling to the country to receive treatment through the public system. That phenomenon, they say, justifies changing the current conditions of access.

PSD and CDS-PP want to strengthen mechanisms to identify who is financially responsible for each instance of care and to make subsequent collection easier. The text opens the door to financial guarantees or advance payments in certain cases. The proposal was registered on **25 September**.

## PCP responds that the problem is structural

The **Portuguese Communist Party (PCP)** rejected the approach. It accused the government of focusing the debate on foreigners to avoid addressing structural problems in the SNS, such as the lack of professionals and insufficient investment. The criticism came on Sunday.

This is not the first time PSD and CDS-PP have pushed for such a reform. A similar initiative passed an initial vote during the previous parliamentary term with the support of **Chega**, but its passage was halted after early elections were called. The new text takes up that approach with changes.

The proposal comes amid greater political pressure over immigration in Portugal, where the growth of the foreign population has placed the issue among the main topics of national debate.

## What would change if the reform goes ahead

The reform would amend the **Basic Health Law** to redefine access to the **SNS**. Foreigners with legal residence would keep free care. Those in an irregular situation would have to pay for care or first prove that they have coverage.

Emergency care and life-threatening cases would continue to be treated regardless of the patient's administrative status. Documentation would then be requested to decide who pays. The text also proposes financial guarantees or advance payments in some cases.

The legislation is under consideration and has not been approved. Such a change affects legal rights and obligations, so it is advisable to consult current regulations and a professional before deciding anything.