What it is
Public health care for everyone who lives in Spain
It is a royal decree-law. It was introduced on 30 July 2018. Introduced by: Gobierno.
Official title: Royal Decree-Law 7/2018, of 27 July, on universal access to the National Health System.
Source: Congreso de los Diputados, file 130/000034· updated 11 Nov
Automatic summary, not yet reviewed
- All people with Spanish nationality and foreign people who live in Spain are holders of the right to health protection and health care. This restores the universality that the 2012 rule had limited.
- The Ministry of Health, Consumer Affairs and Social Welfare recognizes and controls this right, and access is made effective through the individual health card. Immigration bodies may share data without the person's consent to verify the requirements.
- Foreign people who are not registered or authorized as residents in Spain have the right to health care under the same conditions as Spanish nationals, as long as there is no other coverage route, they cannot export the right from their home country, and no third party is required to pay. This care does not cover them outside Spain.
- Foreign people who are not registered or authorized as residents will pay 40% of the retail price for medicines.
- The rule defines who counts as insured and who counts as a beneficiary under international Social Security rules and for pharmaceutical copayments. Beneficiaries include a spouse or partner and dependent children under 26 or with a disability of 65% or more.
- Special health care agreements held by people who now qualify for publicly funded care stop being valid at the end of the month when this rule takes effect. Articles 2 through 8 of Royal Decree 1192/2012 are repealed, and the rule takes effect the day after its publication in the Official State Gazette.
Who it affects
- Foreign people without legal residence in Spain: They regain the right to public health care under the same conditions as Spanish nationals, and pay 40% of the price of medicines.
- People with Spanish nationality and foreign residents in Spain: They are recognized as holders of the right to health protection and health care.
- Dependent family members of insured people: A spouse or partner and dependent children under 26 or with a disability of 65% or more can be beneficiaries, under conditions.
- People who had a special health care agreement: Their agreement stops being valid when the rule takes effect, if they already have the right to publicly funded care.
Words worth knowing
- Real decreto-ley (royal decree-law)
- A rule with the rank of a law that the Government can pass urgently, without going through the full parliamentary process first.
- Convenio especial (special agreement)
- An agreement by which a person pays a fee to receive public health care when they do not have the right to it any other way.
- PVP
- Retail price, that is, what the medicine costs at the pharmacy.
- Tarjeta sanitaria individual (individual health card)
- A card that proves each person's right to receive health care and makes it easier to access services.
It summarizes the law as published in the BOE. It is written by artificial intelligence and may contain mistakes: the official text is what counts. Read the official text · How we make summaries
Where it stands
How far did it get?
It took 7 of 7 steps. It reached BOE, and today it is passed.
- Introduced30 July 2018Someone registers the text in the Congreso.
- Admitted4 September 2018The Bureau of the Congreso accepts it and, for a members’ bill, the plenary decides whether to consider it.
- Amendmentsno dateGroups propose changes.
- Committeeno dateA committee goes through the text in detail.
- Plenary4 September 2018All 350 deputies vote.
- Senateno dateThe Senate can pass it, amend it or veto it.
- BOEno dateIt is published in the Official State Gazette (BOE) and comes into force.
See the 4 official steps on a timeline
6 September 2018
How did the plenary vote?
Voted on: Processing as a Government bill by the urgent procedure of Royal Decree-Law 7/2018, of 27 July, on universal access to the National Health System.
This law had 2 votes; this is the latest with every deputy’s vote. See them all
Source: Congreso de los Diputados, vote 4 of sitting 137· updated 10 Nov
Each dot is a seat. Tap one, or use the arrow keys, to see who it is.
Your province
How did the deputies from your province vote?
And your senators: the Senate does not link its votes to this law in its open data, so we cannot put them side by side here.
Or see how most of each province voted
- A Coruña More votes in favour 8 yes · 0 no
- Albacete More votes in favour 4 yes · 0 no
- Alicante/Alacant More votes in favour 12 yes · 0 no
- Almería More votes in favour 6 yes · 0 no
- Araba/Álava More votes in favour 4 yes · 0 no
- Asturias More votes in favour 8 yes · 0 no
- Ávila More votes in favour 1 yes · 0 no
- Badajoz More votes in favour 6 yes · 0 no
- Barcelona More votes in favour 30 yes · 0 no
- Bizkaia More votes in favour 8 yes · 0 no
- Burgos More votes in favour 4 yes · 0 no
- Cáceres More votes in favour 4 yes · 0 no
- Cádiz More votes in favour 9 yes · 0 no
- Cantabria More votes in favour 5 yes · 0 no
- Castellón/Castelló More votes in favour 5 yes · 0 no
- Ceuta More votes in favour 1 yes · 0 no
- Ciudad Real More votes in favour 5 yes · 0 no
- Córdoba More votes in favour 6 yes · 0 no
- Cuenca More votes in favour 3 yes · 0 no
- Gipuzkoa More votes in favour 5 yes · 0 no
- Girona More votes in favour 5 yes · 0 no
- Granada More votes in favour 7 yes · 0 no
- Guadalajara More votes in favour 3 yes · 0 no
- Huelva More votes in favour 5 yes · 0 no
- Huesca More votes in favour 3 yes · 0 no
- Illes Balears More votes in favour 8 yes · 0 no
- Jaén More votes in favour 5 yes · 0 no
- La Rioja More votes in favour 4 yes · 0 no
- Las Palmas More votes in favour 8 yes · 0 no
- León More votes in favour 3 yes · 0 no
- Lleida More votes in favour 4 yes · 0 no
- Lugo More votes in favour 4 yes · 0 no
- Madrid More votes in favour 33 yes · 2 no
- Málaga More votes in favour 11 yes · 0 no
- Melilla More votes in favour 1 yes · 0 no
- Murcia More votes in favour 10 yes · 0 no
- Navarra More votes in favour 4 yes · 0 no · 1 abst.
- Ourense More votes in favour 4 yes · 0 no
- Palencia More votes in favour 3 yes · 0 no
- Pontevedra More votes in favour 7 yes · 0 no
- Salamanca More votes in favour 4 yes · 0 no
- Santa Cruz de Tenerife More votes in favour 7 yes · 0 no
- Segovia More votes in favour 3 yes · 0 no
- Sevilla More votes in favour 10 yes · 2 no
- Soria More votes in favour 2 yes · 0 no
- Tarragona More votes in favour 5 yes · 0 no
- Teruel More votes in favour 3 yes · 0 no
- Toledo More votes in favour 6 yes · 0 no
- Valencia/València More votes in favour 16 yes · 0 no
- Valladolid More votes in favour 5 yes · 0 no
- Zamora More votes in favour 3 yes · 0 no
- Zaragoza More votes in favour 6 yes · 0 no
More details: how each group and each province voted
The groups
Who voted in favour and who against?
In favour, most of Socialista, Vasco (EAJ-PNV), Mixto, Ciudadanos, Gcup-ec-em, GER and Popular en el Congreso. 5 deputies voted differently from their group.
By province: in 52 most voted in favour; in 0, against.
Coloured by how most of each province’s deputies voted.
- In favour: 52
- Against: 0
| Group | Seats | How it voted |
|---|---|---|
| Socialista | 84 | 84 in favour |
| Vasco (EAJ-PNV) | 5 | 4 in favour · 1 did not vote |
| Mixto | 19 | 17 in favour · 1 abst. · 1 did not vote |
| Ciudadanos | 32 | 31 in favour · 1 did not vote |
| Gcup-ec-em | 67 | 62 in favour · 4 against · 1 did not vote |
| GER | 9 | 7 in favour · 2 did not vote |
| Popular en el Congreso | 134 | 131 in favour · 3 did not vote |
What happens next
What happens now?
It is law, or will be once published in the BOE. It comes into force on the date its own text sets.
Published in the BOE: Royal Decree-Law 7/2018, of 27 July, on universal access to the National Health System.
Sources
Where does all this come from?
- Congreso de los Diputados, file 130/000034
Official title, type, author, dates and stage.
Retrieved 11 November 2026
- Congreso de los Diputados, vote 4 of sitting 137
The count and every seat’s vote.
Retrieved 10 November 2026
- BOE, BOE-A-2018-10752
The law as published.
Retrieved 11 November 2026
- The data comes from the open files of the Congreso, the Senate and the BOE, unaltered.
- Each deputy’s province is the one of their seat on the day of the vote.
- We only say “passed” or “rejected” when the majority needed is certain; otherwise we say which side had more votes.