Right to health and access to healthcare for undocumented migrants in Italy: current legal framework and practice

The link between migration and health relates to different fields, from development to human rights, public health and migration governance. Health protection is recognised internationally as a fundamental human right, due to which individuals are entitled without any discrimination of race, sex, nationality, political or religious opinion. Member states of the United Nations have committed themselves to achieving universal health coverage (UHC) by including it among the 2030 Sustainable Development Goals (SDGs). UHC implies that everyone should have access to essential, quality and affordable health services. The 2030 Agenda's principle of 'leaving no one behind' requires giving greater attention to the most vulnerable groups in the realisation of the SDGs. Yet, migrants and, in particular, irregular migrants in a more vulnerable condition are often denied their human right to health. Lack of legal status in the country of residence makes irregular migrants more at risk of adverse health outcomes due to social marginalization, poor living environments, exploitative working conditions and lack of access to health and social services. In many European countries, undocumented/irregular migrants can only access emergency healthcare. When they have legal entitlements on paper, other obstacles such as the fear of being reported or linguistic and administrative barriers prevent them from seeking help and accessing healthcare. Italy scores 79/100 on the MIPEX index measuring health integration of migrants, one of the highest scores among EU countries. Italy chose an inclusive health policy towards immigrants, progressively extending health coverage to refugees and asylum seekers and granting access to secondary care to irregular migrants. This work will focus on analysing the Italian legislative framework on the right to health for irregular immigrants and the difficulties that persist in accessing health services. In the first chapter I will briefly explore the concept of migration as a social determinant of individual health and I will provide an overview of the normative instruments protecting the right to health at the international and European level. In the second chapter I will dive into the Italian legislative framework, focusing on the constitutional provision on the right to health and the immigration legislation that progressively expanded the entitlement to healthcare for undocumented immigrants. Finally, in the last chapter I will review the available literature to highlight persisting gap in the health protection of irregular migrants in Italy.