EU Citizens' Transnational Rights and Health-related Deservingness at the Street-level

The recognition of transnational healthcare rights of EU migrant citizens is a precondition for free movement within the Union.

Although progressive coordination has been fostered by EU laws, the existence of bureaucratic barriers affecting the realisation of EU citizens’ rights at the point of access to Member States’ healthcare systems has been frequently reported.

EU-TRHeaDS investigates how, why and to what extent street-level bureaucrats discriminate against EU migrant citizens who require access to public healthcare.

It will combine qualitative policy analysis methodology with a survey experiment with street-level workers operating at the front-line of healthcare services in two Belgian Regions and two Spanish Autonomous Communities.

In doing so, it will isolate the causal effect of citizens’ identity markers on street-level decisions, while assessing the impact of different political contexts and types of healthcare systems on street-level work.

Theoretically, EU-TRHeaDS links the street-level bureaucracy perspective in public administration studies with the nascent debate on health-related deservingness to test the institutional, political and individual determinants of street-level decisions.

Empirically, it fills two gaps in the welfare-mobility nexus scholarship, shifting the focus from welfare to healthcare entitlements, and focusing on implementation practices rather than on countries’ formal policies.

Methodologically, it provides a comprehensive approach to the study of street-level decisions, carrying out an original comparative research that combines qualitative and experimental methods.

Substantively, EU-TRHeaDS unveils how the complex equilibrium between EU citizens’ transnational rights and Member States’ bounded healthcare systems materialises, which is critical in times of renewed debates on “Social Europe” and the challenges posed by COVID-19 to intra-EU mobility.