The first victims of Citizenship Law are women

The recently published regulations governing the application of the National Health Insurance Act to Palestinians from the West bank and Gaza who are married to residents and citizens of Israel, systematically discriminate against this group. In imposing unique financial demands, these regulations prevent them from properly accessing medical care, thereby compromising their right to health. Earlier this week, Physicians for Human Rights-Israel (PHRI), together with St. Eves, appealed to the High Court of Justice to demand mechanisms that would provide discounts and exemptions that would enable these families to access their right to health.

The 2003 “temporary directive” to the Citizenship Law prevented the roughly 8,000 Palestinians who are married to Israeli citizens and residents from becoming Israeli residents, thereby also denying them access to health and welfare services in Israel. A petition by PHRI and other human rights originations in 2009 resulted in the extension of the National Health Insurance Act, which applies to all Israelis, to this group of Palestinians, and thereby ensured their access to Israeli health services, despite their non-residency.

Initially seen as a huge achievement, these newly passed regulations discriminate between Palestinians and Israelis as they impose on the latter financial obligations without providing exemptions and discounts to those in need, as is the case with their Israeli counterparts.

As per these regulations, Palestinians married to citizens must submit a payment of 6 months in arrears to Health Maintenance Organizations, while those married to residents must submit a payment of 27 months in arrears, on top of the monthly 285 NIS fee. These retrospective payments amount to 1,710 NIS and 7,650 NIS respectively, indicating discriminatory political considerations in the differential treatment of citizens and residents.

These regulations not only exact these significant financial obligations, but moreover — in contrast to Israeli citizens — unless payment is made, regular health services will not be provided.

Such large debts can essentially further impoverish families, especially as in the context of East Jerusalem over 70% of families already live under the poverty line. The only real option available to these individuals is to pay these exorbitant fees: letters from the Ministry of Health have already been received by these families reminding them of their ‘debt’ and notifying them that all health services will be terminated unless payment is immediately made. Meanwhile, these same regulations have annulled previously available private tourist insurance used by this group, leaving them no recourse to additional insurance options..

Furthermore, as those impacted by the Citizenship Law are Palestinians without citizenship or residency who are here on continuously renewed permits, it is also unclear whether their inability to pay will impact their ability to receive such permits.

Among the roughly 20,00 impacted include the following cases:

Hamdi, a 74 year old who is married to a resident of East Jerusalem. They have 5 children and are unable to work, relying on their older children who provide them with 1,500-2000 nis a month. Their financial situation leaves them unable to pay the required sums, leaving Hamdi unable to receive treatment for his various medical problems.

Azhar, who is married to a resident of East Jerusalem. They have 3 children. Azhar’s husband is severely disabled and unable to provide for the family. Their only income is his disability payments which amount to 4,000 nis a month. Their financial situation leaves them unable to pay the required sums.

Although the extension of the National Health Insurance Act to this grouping recognizes these Palestinians’ right to health, its current implementation still compromises this right, in contrast with Israelis served by the same legislation. For this reason, PHRI has turned to the High Court of Justice to request the provisions of mechanisms that would allow this group to fully access their right to health.