Asylum Seekers’ Health Insurance Program at Risk as Israeli Providers Back Out

17.06.23, Bar Peleg, Haaretz

Asylum Seeker Community

Healthcare

Israeli government policy

The deadline for Israeli health insurance providers to bid on a government contract to provide coverage for asylum seekers expired last week without a single bidder vying for the contract, putting the entire program in jeopardy.

Although the deadline for bidding on the tender expired last week, it was issued just before the November 1 election by then-Health Minister Nitzan Horowitz. On Monday, a meeting of the ministry’s tenders committee ended without making a decision on next steps. Health and Interior Minister Arye Dery’s office said it was examining the matter.

Under the terms of the tender, the health insurance including a deductible for people without legal status was supposed to provide coverage for some 20,000 adults.

A month after the Bennett-Lapid government was formed in June 2021, Haaretz reported that the health ministry was seeking 20 million shekels ($5.8 million) from the state budget to serve as the program’s foundation. Horowitz announced the program on his Facebook page and touted it as an achievement for his Meretz party.

Following an administrative process, including deliberations by an interministerial committee, the Health Ministry issued the tender at the end of last October. Since then, the tender’s deadline has been extended three times, but it failed to draw a single bid.

The Health Ministry must now decide whether to issue a revised tender, to run the program differently or to drop the project altogether. In the current political reality – in light of the coalition agreements reached by the Netanyahu government partners, in which they pledged to expel asylum seekers – the program appears to be in jeopardy.

According to a question-and-answer file published by the ministry, insurance companies feared that the terms of the program would encourage policyholders not to pay their premiums because they could expect to get coverage anyhow. As a result, one insurer insisted that coverage be halted for non-payment and that the ministry be responsible for collecting premiums. The ministry refused.

Another concern raised by insurers was about debts amassed by policyholders who didn’t pay premiums. The ministry replied that bidders must weigh the costs and risks as part of their bids and that the insurance companies are responsible for debt collection.

One other issue raised by the bidders was that the tender terms encouraged people to sign up for insurance after they have become sick because they can’t be denied coverage for pre-existing conditions. The insurers demanded that the policyholders had to show 36 months of continuous residence in Israel rather than the previous requirement of 27 months. They also asked that the four-month run-up before the program’s start be extended to a year. The ministry did not agree to either demand.

“The news that not a single company submitted a bid in the tender is disturbing,” said Tali Ehrenta, executive director of the Aid Organization for Refugees and Asylum Seekers in Israel, known as Assaf.

“For years Assaf has been seeing the health deteriorate – both physical and mental – of refugees and asylum seekers from Africa. They are part of the most vulnerable populations: survivors of torture camps in Sinai, the mentally challenged, people with disabilities, the elderly and others. Without health services, their condition will continue to deteriorate, and they find it difficult to get even the few welfare services offered to them by the Welfare Ministry.”In July 2018, the Health Ministry issued a public tender to operate urgent-care clinics for people in Tel Aviv without legal status. The terms required providers to serve populations in Be’er Sheva, Jerusalem and Haifa, but the bidding was suspended.

“The Health Ministry has long recognized the medical and moral reasons, as well as the public health and economic considerations requiring a systematic response to the refugee population that has lived in Israel for more than a decade and suffers from chronic neglect of its health,” Zoe Gutzeit, director of the Physicians for Human Rights’ The Bella Kaufman Open Clinic.

“For more than a year, the Health Ministry has said again and again, including the High Court, that it plans to create a subsidized insurance program for asylum seekers, but unfortunately the ministry chose to abdicate full responsibility and assigned the task to the private insurance companies. Now it’s become clear that the private sector isn’t ready to undertake the government’s obligation towards the refugees.”

Original article