Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank the Senator for raising this matter. I note his continued engagement with the Minister for Health and his Department on this issue. The requirement for international students to have health insurance is a matter of immigration policy, which is the responsibility of the Minister for Justice.

I acknowledge the Senator's dedication to this issue and understandable frustration at a lack of response. I, too, am frustrated that he tabled a Commencement matter on this issue on 9 December last, to which I responded, raised it again during the Second Stage debate on the Health Insurance (Amendment) Bill 2021 when the Minister of State, Deputy Butler, was in the House, and raised it again on 15 December last. On all of those dates, the Senator was informed that work was being done by officials in both the Departments of Health and Justice and a resolution was hoped for in a matter of weeks. Unfortunately, it has not been possible to resolve this matter yet. However, I have been informed that communication is continuing between both Departments on this issue. My brief includes a statement that "I hope it will be possible to resolve in the near future". That response is not good enough.

As I have said, students are coming to Ireland. They are required to hold health insurance as part of the conditions of securing a visa. As immigration policy is a matter for the Minister for Justice, this seems to be an issue. I will give an account of the rationale behind our community-rated health insurance market and where the regulatory mechanisms for it intersect with this issue, as this matter falls within the remit of the Department of Health. I will also describe supports community rating gives to older and sicker people who decide to avail of health insurance.

As the Senator will know, we have a voluntary and community-rated market in Ireland. This means there is no requirement for any person to procure private health insurance under Irish health insurance legislation. Community rating means that when people decide to purchase health insurance they are not risk-rated and, therefore, not discriminated against on the basis of age, gender or health status. This is long-established Government policy and ensures that health insurance policies are affordable for everyone.

In order to maintain a policy of community rating and under the Health Insurance Acts, any person who is ordinarily resident in the State and purchasing private health insurance must buy a community-rated health insurance policy from a registered insurer. This ensures the products these consumers are buying are regulated by the independent regulator of health insurance, namely, the Health Insurance Authority. Providers who sell health insurance to consumers must also comply with the provisions of the Health Insurance Acts relating to open enrolment, community rating, lifetime cover and minimum benefits.

The current issue regarding international students and health insurance arose because travel insurance-type products were being sold to students who were here for longer than one year, in which case those buying health insurance should purchase a community-rated health insurance product. This was the subject of court proceedings where the court found in favour of the Health Insurance Authority, which took an enforcement action against the company providing these travel insurance policies to students staying for more than one year.

Irish health insurance legislation does not currently contain any reference to persons who are required to hold health insurance. This requirement is a part of a person's visa checklist when he or she is preparing to come and stay in this country. The policies and procedures around visas are not within the Minister for Health's policymaking remit.

What is needed in this regard is cross-Department co-operation. Many months ago, we said this matter would be resolved in the future. It is not good enough that it has not been resolved. I will bring this matter to the attention of my Department and the Department of Justice.