EU court concludes that the UK erroneously insisted on comprehensive sickness insurance for years.

Eligibility for NHS treatment does count as Comprehensive Sickness Insurance, the Court of Justice of the European Union has ruled. The case is C‑247/20 VI v Her Majesty’s Revenue and Customs.

The key pivotal question was not directly asked – so we should be glad that the judges nevertheless took it upon themselves to address it. The preliminary reference asked three questions:

  1. Whether children with permanent residence are also required to have CSI (answer: no, they are not).
  2. Whether the family members of students and self-sufficient persons who did not yet have permanent residence are required to have CSI (yes, they are); and
  3. Whether the Common Travel Area arrangements between the UK and Ireland amounted to CSI (insufficient information).

What has the Court of Justice eventually said?

The key paragraphs of the judgement are:

The applicants were affiliated during the period in question… to the United Kingdom’s public sickness insurance system offered free of charge by the National Health Service..

… once a Union citizen is affiliated to such a public sickness insurance system in the host Member State, he or she has comprehensive sickness insurance within the meaning of the relevant legislation.

The court found that a member state could theoretically set conditions for EU nationals in this position, such as a requirement to have private insurance before being allowed to register with the NHS, or to have paid into the public sickness insurance system.

But the UK had never imposed any such conditions, and the court suggested that it would not have complied with the principle of proportionality to impose such conditions in this case: “It cannot be considered that that affiliation free of charge constitutes, in such circumstances, an unreasonable burden on the public finances of that State”.

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