An estimated 11,000 to 14,000 people living in Zurich without valid health insurance could benefit from the service. The healthcare initiative started as a pilot project in 2022 and is backed by annual funding of 2 million euros.
Zurich’s city parliament has approved an annual budget of 1.9 million Swiss francs (2 million euros) to fund healthcare access for uninsured individuals, including people living in the city without legal residence status, often referred to as sans-papiers, the Swiss news outlet Alipine Weekly reported on Monday, January 12.
Previously, people without health insurance were generally limited to emergency medical care only. Under the new policy, coverage will be expanded to include the treatment and management of chronic conditions, such as diabetes and high blood pressure.
With this decision, Zurich becomes the first city in German-speaking Switzerland to introduce free basic healthcare for people without health insurance, including irregular migrants.
From pilot project to public health service
The healthcare program reportedly operated as a pilot project since 2022. The city parliament voted 86 to 33 in favor of making the programme permanent. Between 11,000 and 14,000 people living in Zurich without valid health insurance could benefit from the service.
Opponents of the policy raised concerns that the programme could attract uninsured migrants to the city. However, supporters, including representatives from the Social Democratic Party (SP), the Greens, and the Alternative Left (AL), rejected these claims. They pointed to the pilot phase, noting that no evidence emerged that Zurich experienced an increase in uninsured residents as a result of the program.
Proponents also argued that providing early access to healthcare helps reduce long-term public costs, as medical conditions can be treated before they escalate into emergencies that place greater strain on hospitals and emergency services.
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Supporting undocumented residents
According to a study, "City Initiative on Migrants with Irregular Status in Europe (C-MISE)", published by the Centre on Migration, Policy & Society (COMPAS) at the University of Oxford, Zurich has undertaken extensive research to improve access to municipal services for people with irregular status since 2018.
The city’s initiatives have included efforts to expand healthcare access for uninsured residents, ensure access to pre-school and compulsory education, as well as removing barriers that prevent undocumented migrants from accessing public services.
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Undocumented workers in Switzerland
According to UNIA Suisse, a Swiss trade union, most workers without regular residence status are employed in low-wage sectors, including domestic work, construction, hospitality, transport, and agriculture.
Official government figures show that 29,459 cases of irregular migration were recorded in 2024, a significant decrease compared with 50,185 cases in 2023.
A recent study on the health of undocumented Central and Eastern European migrants indicates that some arrive in Switzerland having received medical treatment in their countries of origin, but are often left without access to ongoing care once in Switzerland. Without health insurance, they typically seek medical attention only in emergencies and may be refused treatment or discharged after very short hospital stays.
The research findings indicate that this combination of individual vulnerability and barriers to access increases health risks and deepens social exclusion, making integration more difficult for undocumented migrants.
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