Seanad debates

Wednesday, 22 June 2022

Nithe i dtosach suíonna - Commencement Matters

Insurance Coverage

10:00 am

Photo of Malcolm ByrneMalcolm Byrne (Fianna Fail)
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I am always happy to see the Minister of State in the House but I am disappointed because I tabled this matter for the Department of Justice and it was transferred to the Department of Health. In December last, I tabled the exact same Commencement matter. Before I list chronologically some of the delays and problems around this, I will refer to the Minister of State's response to my Commencement matter on 9 December 2021. This is around the question of international students' health insurance. The Minister of State said:

As outlined in my opening reply, this issue concerns international students coming to study in Ireland who are required to adhere to particular immigration visa requirements, one of which relates to having private health insurance. I repeat that it is not within my policymaking role within the Department, as the Senator said. Officials in my Department have been engaging with officials in the Department of Justice to see if this requirement should be necessary for these students at all. It is good that those discussions are at an advanced stage and, in the coming weeks, I hope to have some positive progress to communicate to the Senator. Perhaps in two months, or certainly at some time next year, this issue will be resolved.

I first raised this issue in 2020, not long after I came into this House. The failure to address the question of health insurance for international students is potentially prohibiting a number of international students from coming here. As I communicated to the Minister of State in December of last year, this is an issue that falls between a number of Departments.

On 24 September 2020, I raised this matter with the Minister for Further and Higher Education, Research, Innovation and Science, Deputy Simon Harris, and I have also raised it with him at Oireachtas committees. I have also raised the issue with the Minister for Health, Deputy Stephen Donnelly. Every time I raise it, I am told that negotiations are taking place between officials.

On 5 March 2021, I introduced the Health Insurance (International Students) (Amendment) Bill, with the aim of addressing this matter. I engaged in discussions with the Department of Health and was told that discussions were taking place in other Departments. I decided not to proceed with an amendment to the Health Insurance (Amendment) Bill 2021 because I was assured at the time that this matter would be addressed. As the Minister of State will recall, that assurance was given just a week after a Commencement debate taken by the Minister of State, Deputy Butler. In response to me, the Minister of State said:

I know this is causing a lot of bother for students from non-EEA countries studying in Ireland. I understand the officials are engaging on this and that there will be a positive update in the new year.

In February 2022, I raised this issue again on the Order of Business in this House. I have regularly raised it with officials in the Department of Health. Clearly, somebody in either the Department of Health or the Department of Justice is not doing his or her job. This situation cannot continue. For two years, I have been told that progress is being made, yet we are no further on since I first raised this issue in 2020. It is the international students who are impacted and losing out.

Last December, the Minister of State, Deputy Feighan, gave me a commitment in good faith that the issue would be resolved within two months. While I have no doubt his approach to this matter is genuine, it is simply not acceptable that a number of Departments are supposed to be sorting out this matter and somebody is clearly not doing his or her job.

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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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.

Photo of Malcolm ByrneMalcolm Byrne (Fianna Fail)
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I seek the guidance of the Acting Chairperson. Is it possible for me to withdraw my Commencement matter? With all due respect to the Minister of State, and I am not criticising him personally, his reply is the exact same as the one he gave me last December. I know that because I compared the reply the contents of the two replies and they are almost word for word. I am not satisfied with the response and for this reason, I seek to withdraw my Commencement matter and direct it to the Minister for Justice. Is that possible?

Officials in the Department have indicated there has been progress but the delay is with the Department of Justice. No progress has been made for two years. We have heard about talks and discussions but nothing has happened, despite Ministers in a number of Departments giving commitments that there will be discussion or engagement on this matter. I ask that the Minister for Justice be invited to the House. I appreciate that may not be possible with a Commencement matter. I reiterate that the reply I received is not acceptable. I ask the Minister of State, at a minimum, to give a commitment that I will get an answer in writing within the next week from the Minister for Justice outlining progress.

Photo of Erin McGreehanErin McGreehan (Fianna Fail)
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Unfortunately, the Senator cannot withdraw his Commencement matter as it has already been taken. However, he can submit another Commencement matter directed at the Minister for Justice in the hope that she will come to the House. He can also request a debate on this issue during the Order of Business.

Photo of Malcolm ByrneMalcolm Byrne (Fianna Fail)
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On a point of order, normally one cannot resubmit a Commencement matter. As today's Commencement matter was answered by the Department of Health, can I submit the same Commencement matter but insist that the Minister for Justice answers?

Photo of Erin McGreehanErin McGreehan (Fianna Fail)
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Yes, if the Commencement matter is directed to the Minister for Justice and it is accepted, it will be considered a new Commencement matter.

Photo of Malcolm ByrneMalcolm Byrne (Fianna Fail)
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I thank the Acting Chairperson.

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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As I stated in my opening remarks, unfortunately it has not been possible to secure an agreement on these matters yet. However, I am informed by the Department of Health officials that communication is ongoing and that both Departments are working towards a solution. I take the officials at their word. Although this matter is not directly within the Minister for Health's policymaking role to determine immigration requirements and procedures, officials in the Department of Health have been engaging with officials in the Department of Justice to see if this requirement should be necessary for these students.

Again, I thank the Senator for his contribution and for raising this issue. As outlined, there are issues concerning international students coming to study in Ireland. They have particular immigration visa requirements related to having private health insurance. The Departments of Health and Justice need to redouble their efforts to overcome these anomalies or obstacles. Unfortunately, it has not been possible so far to secure an agreement.I am not privy to what is going on. I am quite sure that work has been going on between Departments. I hope we can get an agreement on this as soon as possible. I will bring the concerns of the Senator directly to the Minister.