Access to health care for precarious EU movers in times of crisis: hierarchies of health-related deservingness in the Spanish and Italian universalistic health care systems

Abstract

The definition of intra-EU mobility has been accompanied by advancing coordination in the field of social protection across the EU, including health care. Although EU law guarantees equal access to health care in a host Member State for employed or self-sufficient EU citizens, some countries broadened eligibility criteria over time to include precarious EU citizens. In times of economic downturn and widespread concerns about „welfare tourism‟, however, restrictions in access to health care have been debated and even introduced against those mobile EU citizens who have been increasingly perceived as a burden on the national healthcare system. By focusing on policies regulating access to health care for precarious EU citizens in the Italian and Spanish universalistic health care systems, this study explores the ways in which health-related deservingness of mobile EU citizens has been (re)defined in times of crisis. It suggests that, in these countries, different measures regulating access to health care for precarious EU citizens reflected different national health care models and policy traditions concerning the healthcare-irregular migration nexus. Under the guise of the economic crisis and the need to fight (a supposed) „medical tourism‟, however, both countries introduced restrictions in eligibility criteria and complex procedural requirements largely affecting precarious EU citizens, converging in policy measures aimed at excluding the undeserving „illegal EU migrants‟ from the realm of social citizenship.