Spain’s Health Ministry has released a draft royal decree that would make it easier for non-resident foreigners—including frequent business travellers, seasonal workers and digital nomads—to access the state healthcare system. Published for public consultation on 23 October 2025, the text proposes accepting a broader set of documents—such as town-hall ‘padrón’ registration, school enrolment certificates or recent utility bills—as proof of ‘effective residence’.
The move builds on a 2024 cabinet pledge to restore universality after regional cutbacks left many visitors facing hospital bills. Under the draft, foreigners who spend significant periods in Spain but lack formal residence permits could enrol at local health centres once they demonstrate their connection to the community. Spaniards living abroad would also gain clearer rights when they return temporarily.
For global mobility teams the reform would reduce reliance on private medical insurance during short-term assignments. Employers could see lower costs if staff become eligible for free primary care and subsidised prescriptions. However, the decree is still subject to amendments and must navigate a fragmented parliament; regional governments may impose additional paperwork.
Healthcare providers are cautiously supportive, noting that clearer eligibility rules should cut administrative disputes and emergency-room debt. Critics on the right argue the plan could encourage ‘health tourism’, while migrant rights groups say it does not go far enough because irregular migrants still face barriers if they cannot show documentation.
Stakeholders have until mid-November to submit comments. If enacted in early 2026, HR departments should update pre-assignment checklists to capture acceptable proofs of residence and inform non-resident employees about registration steps at local health centres.
The move builds on a 2024 cabinet pledge to restore universality after regional cutbacks left many visitors facing hospital bills. Under the draft, foreigners who spend significant periods in Spain but lack formal residence permits could enrol at local health centres once they demonstrate their connection to the community. Spaniards living abroad would also gain clearer rights when they return temporarily.
For global mobility teams the reform would reduce reliance on private medical insurance during short-term assignments. Employers could see lower costs if staff become eligible for free primary care and subsidised prescriptions. However, the decree is still subject to amendments and must navigate a fragmented parliament; regional governments may impose additional paperwork.
Healthcare providers are cautiously supportive, noting that clearer eligibility rules should cut administrative disputes and emergency-room debt. Critics on the right argue the plan could encourage ‘health tourism’, while migrant rights groups say it does not go far enough because irregular migrants still face barriers if they cannot show documentation.
Stakeholders have until mid-November to submit comments. If enacted in early 2026, HR departments should update pre-assignment checklists to capture acceptable proofs of residence and inform non-resident employees about registration steps at local health centres.
