Regions left to handle those now deprived of health card

Starting Saturday, 910,342 foreigners will lose their public system health card in a move that the government hopes will save around 1.5 billion euros a year.

 The Health Ministry explained that the measure is aimed as a “deterrent” that will prevent a “pull effect” on non-residents seeking free health assistance from Spain.

Each regional government must now figure out how to charge foreigners for medical assistance, or whether it takes on those costs itself, especially when it comes to the nearly 150,000 illegal immigrants living in Spain.

The Popular Party administration figures that around 500,000 card carriers are not registered as living in Spain and might have been “health tourists” at some point, meaning they came to Spain for surgery. This group is the main target of the reform; 30 percent are European citizens and the rest hail from other countries.

The government said the move will bring Spain in line with most other European countries.

Deputy Prime Minister Soraya Saénz de Santamaría insisted that nobody will be left out of the system who needs medical aid, but the central government failed to provide a unified mechanism to manage a system that will no longer be free for all.

Even if they are deprived of their health card, foreigners will still have access to free emergency services, pregnancy and delivery assistance, as well as treatment of communicable diseases. Minors will still have the right to complete health coverage. All other types of assistance will no longer be free for non-residents.

Some of those foreigners will have their costs covered by their own countries by virtue of reciprocity agreements. Ecuador on Friday expressed a desire to sign a deal to ensure Ecuadorians in Spain receive free medical assistance.

Some regions such as the Basque Country, Asturias and Andalusia announced they will disobey the measure and assume the costs of medical attention. Others, like Galicia, will give illegal migrants a six-month period from their first visit to the doctor to prove their lack of funds.