has the mortality of undocumented immigrants increased by 20% in Spain after the reduction in aid?

2023-11-09 09:20:00

Health Minister Aurélien Rousseau denounced the “mistake” of the Senate, which adopted the abolition of state medical aid for undocumented migrants. Spain has already done this for six years before turning around, faced with worrying health consequences.

It is a vote denounced by both Prime Minister Élisabeth Borne and Doctors Without Borders. The Senate, with a right-wing majority, adopted the abolition of state medical aid for foreigners in an irregular situation in France, during a vote on Tuesday, November 7. He proposes replacing it with emergency medical aid only, thereby reducing the scope of medical reasons covered by the State for undocumented immigrants.

Nothing is definitive because the National Assembly has yet to decide on the subject. But the Minister of Health Aurélien Rousseau still deplored a “error” which borders on the “mistake”in the show Daily the same evening. He recalled that “Spain tried this device [entre 2012 et 2018] . After a few years, they realized that they had 20% more mortality in this population which is much more prone to communicable diseases, etc.. And that’s true.

22% increase in mortality among undocumented immigrants after three years in Spain

Spain restricted medical aid to illegal foreigners in 2012. Their mortality rate immediately began to increase, year after year, reaching an increase of 22.6% in 2015, according to a study by the University of Barcelona entitled “The Deadly Effects of Losing Health Insurance”, published in 2018 (in English). Smoothed over the first three years post-reform, from 2013 to 2015, the mortality rate increased by 15% on average per year, or 70 additional deaths per year, in particular due to the cessation of certain medical treatments.

To reach this conclusion, this study compared the evolution of the mortality of undocumented immigrants to that of Spaniards, before and after the 2012 reform. It found that before this reform, the mortality rate of undocumented immigrants followed the same downward curve as that of the Spaniards, while after the reform the curves began to follow opposite paths. The mortality of Spaniards continued to decline, on average, while that of undocumented immigrants began to increase exponentially again.

Another study from the University of Barcelona, ​​published the same year and entitled “The effects of the exclusion of undocumented migrants from health coverage in Spain” (in English), underlines the other consequences on the health of foreigners in an irregular situation, in particular an increase in cases of hepatitis B and an increase in mortality linked to the AIDS virus.

The same objectives in France and Spain…

It should be noted, however, that the French senators do not want to do exactly the same as the Spanish. The amendment adopted by the senators which replaces state medical aid (100% coverage of the health needs of undocumented immigrants) with emergency medical aid provides that serious illnesses, acute pain and care linked to pregnancy will be covered, as was the case in Spain after the 2012 reform. But French emergency medical aid would also cover regulatory vaccinations and preventive medicine examinations.

On the other hand, what really brings the Spanish example closer to the amendment voted for by the French senators is their motivations. Both were aimed at saving money – state medical aid cost nearly 1.2 billion euros in 2022 according to an information report from the Finance Committee of the National Assembly delivered in May 2023 – and put an end to what the Spanish considered to be “medical tourism” and the French right-wing senators “air call” which attracts migrants to France – a notion contested by the Minister Delegate for Territorial Organization Agnès Firmin Le Bodo who assured the Senate that “the AME is not a factor of attractiveness for candidates for immigration to our country”.

…but Spain has not proven that it is saving money

Except that Spain has failed to prove that these restrictions save money. “The Ministry of Health has not yet published figures showing any savings made by reducing medical aid to undocumented migrants”concluded the study on “The effects of the exclusion of undocumented migrants from health coverage in Spain” in 2018.

On the contrary, the study emphasized that these restrictions “could have caused an increase in visits to the emergency room, since it had become the only form of access to care for many. The data indeed shows an increase in visits to the emergency room in metropolitan areas and in large cities, where the foreign population is the largest. This may have caused an increase in health spending, since emergencies cost the State more than other care.”.

In 2018, after six years of medical restrictions for undocumented migrants with health and economic consequences considered bad, Spain finally turned around and returned to universal health coverage for illegal foreigners.


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