A Milan court has raised the issue of the constitutional legitimacy of healthcare assistance for people with disabilities, after cases concerning Egyptian and Pakistani nationals were tried by it in September.
In the eyes of a court in Milan, current immigration regulations in Italy run counter to articles 3 and 32 of the country's constitution. This, explains the organization ASGI, (Italian Association for Juridical Studies on Immigration) is because most migrants with disabilities are issued a special type of "elective residency" stay permit in Italy, because their disability would already normally guarantee them a welfare income and a residence.
However, the issuing of this type of permit to them complicates matters further down the line, as it entails paying to register for the state healthcare system.
Normally, the 'elective residence' is a type of stay permit in Italy that a foreigner can elect to take out, if they can demonstrate they have the means to support themselves, perhaps a pension or enough savings, without working in the country, and that they also have accommodation. That way, they can stay in Italy without working, but support themselves.
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Fees increase
So part of the regulations governing elective residence, require that migrants holding that type of permit should pay 2,000 euros to register with the state healthcare system. This was also affecting the migrants who held that permit who might have disabilities. If they had been issued with a different type of permit, one most other migrants receive, then they would have had automatic direct access to free healthcare.
ASGI explains that this issue became more of a problem from 2024 onwards, after the Italian government raised the minimum registration fee for those holding an elective permit from 387 euros to 2,000 euros per person.
Most migrants with disabilities, noted ASGI, might be entitled to about 6,000 euros a year in welfare support, which would mean that a third of their annual income would be used to register for the state healthcare system. In a strange irony, they had been issued with that welfare support and the right to stay in Italy precisely because of their disability and health issues, so they would need support from state healthcare perhaps even more than other migrants might do.
ASGI pointed out that their entitlement to the elective residency, then went on to exclude them from urgent and essential healthcare, because being holders of a residency permit, they could not argue that they were in Italy irregularly, that would have given them access to that care, but were instead seen as someone 'not registered' for state health care but in Italy regularly, and therefore excluded from the urgent and essential healthcare services until they registered properly and paid the fees.
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Constitutional legitimacy issues raised
The Milan court raised the question of the constitutional legitimacy of these regulations and upheld petitions made by an Egyptian national in Italy since 2000 and suffering from "schizoaffective disorder with psychotic symptoms" and a Pakistani national in Italy since 2009 who has an "ambulatory deficit."
According to an ordinance signed by the judge Paola Ghinoy, Article 34 of the Italian immigration regulations "distinguishes between the possibility of obligatory registration", i.e.necessary and free of charge, and "the possibility of voluntary registration"; a permit for "elective residence", it states, does not fall under the list of those with a right to registration free of charge.
The state, thus, authorizes "a person with a disability residence to remain on the territory" while at the same time "making it difficult to access healthcare by not allowing obligatory registration with the national healthcare system and establishing a significant cost that becomes unsustainable for many people."
The issue has now been referred to the constitutional court for a final assessment.
ASGI as well as the lawyers collective APN (Avvocati per Niente), and the volunteer group Naga that supports migrants, along with the NGO Emergency expressed their pleasure at the initial judgement.
All four associations said in a statement that they hoped this decision would help "eliminate a situation of extreme injustice."
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