Maria Byrne (Fine Gael)
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I thank the Minister of State for coming to the House to discuss this important topic. My concern is around the rent-a-room scheme. There has been so much encouragement for people to join the scheme. I come from County Limerick, where there are three third level institutions. This morning I received a response from one of them to say that unfortunately, they have no accommodation for the number of people on the waiting list. It is a really serious issue. We, as a Government, have announced that people can earn up to €14,000 tax-free under the rent-a-room scheme. That is fine. However, many older people have approached me about the matter. They have considered joining the scheme, but they are concerned about their medical cards. Specifically, they are worried that joining the scheme would affect their entitlement to those cards and that they would lose that entitlement if they went slightly over the threshold. To me, this is a no-brainer. There is a cost-of-living crisis and people are afraid to turn on their heating. They are worried about their bills and the increasing energy costs. For older people who may be medical card holders, joining the scheme would create income for them in the cost-of-living crisis.

Many of the people to whom I refer are widows or widowers who live on their own. The scheme would enable them to have company at home. It would also help to address the student accommodation crisis. It is not going to solve the overall problem, but it will go a long way towards it. The Minister for Further and Higher Education, Research, Innovation and Science and the Department of Education are very much in favour of the scheme, but the Department of Health has said nothing. That is really why I am raising the issue today. I believe that the Minister for Health, Deputy Donnelly, and his Department need to come out in support of the scheme. I know that the Minister of State is here to deliver the message on behalf of the Minister. I really acknowledge and admire the work that she does. I believe that the scheme is a win-win for all and look forward to hearing what the Minister of State has to say.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator for raising this matter. I am responding on behalf of the Minister for Health, but can I just say that from my own perspective, as Minister of State with responsibility for older people, I am of the view that the rent-a-room scheme is invaluable in light of the challenges we have in the context of accommodation and the pressures that exist. It is also invaluable from the perspective that an elderly person who is living alone could decide to rent out a room under the scheme. Having the company and companionship is important. I spoke to a recently bereaved gentleman who told me that he had taken in a family of two adults and two children from Ukraine. He said that to see clothes hanging on the washing line again gave him such a lift. The rent-a-room scheme is Government policy, so everyone is very supportive of it, but it is really important. It can provide access to income for people who are challenged financially.

As we know, eligibility for a medical card is provided on a statutory basis under the Health Act 1970 and is based primarily on means. As of August this year, there are over 1.5 million medical card holders and in excess of 530,000 GP visit card holders. Therefore, more than 2 million people are availing of support from the State in relation to their health. The Act obliges the HSE to assess whether a person is able, without undue hardship, to arrange general practitioner services, having regard to his or her overall financial position and reasonable expenditure. The HSE medical card assessment guidelines outline certain incomes that are not included within the medical card assessment process, primarily social welfare payments and some compensation payments deemed not assessable. The focus of the Minister for Health continues to be on ensuring the continued operation of an appropriate and effective medical card system, which aims to provide support and access to health services when needed. If an applicant's income is above the limit for a medical card or GP visit card, they may still qualify for a discretionary card. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness.Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing a general practitioner or other medical services, which deals with people who have access to a medical or GP-only card.

On the Senator’s specific question, my understanding is that current rent-a-room tax relief allows people to earn up to €14,000 per year tax free if renting out a room or rooms in their home to private tenants. As we have said, this was also a call-out from the Minister, Deputy Harris, to students who are finding it difficult to access accommodation. Income from the rent-a-room scheme is not currently exempted from the medical card assessment process, as the Senator noted. A proposal to exclude income derived from the rent-a-room scheme from the medical card assessment process needs to be reviewed in detail to determine and consider the range of policy, legislative, operational and financial implications involved.

I assure the Senator the Minister for Health endeavours to ensure that the medical card system is responsive and sensitive to people's needs. The Department of Health keeps medical card issues, including the current medical card income thresholds, under review and any proposals are considered in the context of any potential broader implications for Government policy, the annual budgetary Estimates process and legislative requirements arising.

Maria Byrne (Fine Gael)
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I thank the Minister of State for the comprehensive response. I am a little disappointed because the Minister has not stated that he will carry out a comprehensive review but rather that a comprehensive review is required. He has not committed to anything and that is really disappointing. In this day and age, when students do not have accommodation and when older people face increased costs of living, the Minister needs to review the policy and bring forward a proposal. I ask the Minister of State to revert to the Minister and urge him to reconsider his response on this issue. That is the right thing to do. I have outlined the facts and how it would be a win-win situation for all. We as a Government are encouraging people to rent a room and to attend college, yet this is an impediment. These are such small sums and I am sure that if someone were to exceed the limit, he or she would not do so by thousands of euro. The Minister needs to indicate he will review the issue, rather than just say it requires a review.

Mary Butler (Waterford, Fianna Fail)
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I again thank the Senator for raising the issue and will take on board the points she made, which I will feed back to the Minister. As she will be aware, persons aged 70 or older are assessed under the over-70s medical card income thresholds, which are based on gross income. Income from the rent-a-room scheme is not currently exempt from the medical card assessment process. This issue not only lies with the Department of Health but also with the Department of Finance. On what the Senator said about a proposed review, it is important that a review happen in order that we can see what kind of cost would be involved. Some people might only slightly exceed the threshold, but allowing people to earn €14,000 tax free might incur a huge cost on the State. The only way we can find that out is by reviewing the matter, so I will certainly feed back the Senator's comments. The rent-a-room scheme is very important and it could offer important support to older people who are living alone.