In a landmark move, Spain's government has approved a royal decree enabling undocumented migrants to access publicly funded healthcare, standardizing access across regions and simplifying administrative processes. The new measure, which emphasizes support for vulnerable groups and economic fairness, marks a significant shift in healthcare policy, ensuring immediate medical access and broader eligibility for both residents and Spaniards abroad. DR ‹ › The Spanish government approved, Tuesday, a new royal decree outlining procedures that will allow foreigners residing in the country without legal status to access publicly funded healthcare. The measure was proposed by the Ministry of Health together with the Ministry of Inclusion, Social Security and Migration. Through this regulation, the government aims to standardize the criteria applied across Spain's regions, as previous differences led to unequal access to healthcare services for migrants not registered as residents. One of the key changes introduced by the decree is the simplification of administrative procedures through the use of a «responsible declaration». Under this system, applicants must declare that they do not have alternative health coverage, cannot transfer healthcare rights from their country of origin, and that no third party is responsible for covering their treatment costs. The government has also introduced simplified reading formats and support measures to ensure that people with disabilities can understand and sign the declaration. Simplified procedures Access to the public health system will no longer depend exclusively on registration in the municipal population register. The decree allows other ways to prove habitual residence in Spain, including school certificates for minors, reports from social services, water and electricity bills, or internet contracts in the applicant's name. Healthcare access will be immediate, with applicants receiving a temporary document enabling them to obtain treatment while their request is being processed. Authorities must issue a decision within a maximum of three months. If no response is given within that period, the application will be automatically considered approved. The decree places particular emphasis on vulnerable groups, guaranteeing comprehensive healthcare for children under 18 and pregnant women, including childbirth and postnatal care. It also explicitly recognizes the right of non-resident foreign women to access voluntary termination of pregnancy services. Additional protections are provided for victims of gender-based violence, sexual violence and human trafficking, as well as for individuals seeking international protection. Broader eligibility The scope of coverage is also extended to Spaniards of Spanish origin living abroad and their family members during temporary visits to the country, a right that was previously limited to retirees or workers. As part of efforts to strengthen economic fairness, the decree stipulates that individuals exempt from paying for medications will also be exempt from paying for orthopedic products and assistive devices. In practice, those whose income qualifies them for free medication will not have to pay for these medical supplies. At the same time, the government confirmed that monitoring mechanisms will be introduced to ensure the proper use of public funds. The temporary document may be revoked if inaccurate information or false data is found in the responsible declaration, and the individual concerned may be required to reimburse the full cost of the healthcare services received.
