Do these new NHS rules affect my wife whos on FLR on a spouse Visa?

The Immigration Act came in 2 months ago, not 9. The bill was amended along it's journey.

The Factsheet link you posted earlier, which you quoted from, was dated October 2013. That was 9 months ago.

So I haven't mis-read the Immigration Act? And the NHS levy can be put on any visa route? And only those with UK citizenship or ILR (showing a commitment to the UK) will not have a levy under this Act? And EUs too I assume, under a separate agreement.

If you read the Department of Health document, it states which groups of people will be charged and which won't.

It mentions some specific visa types (workers and students), but not all of them, which is what started this discussion about spousal visas in the first post.

It mentions that people with UK citizenship and ILR will not have a levy.

It mentions that EUs will not have a levy.

I quoted parts of this just a few posts ago - did you not read it?

Obviously, though as this won't be implemented until the 2015/016 financial year, there are likely to be more details and specifics to come in the future.

Wasn't that the figure they used for illustration purposes for the Bill to go through the Houses? I missed the amemdment(?) to the Immigation Act that sets the levy,  would you post that link please.

I didn't say there was an amendment to the Immigration Act. I don't know if there has been or not.

I'm just stating what the link in the OP says about the levy fee. That's all I know about it.

The Act was written so that all visa routes with a visa of over 6 months, could be charged. If they had intended to just impose an NHS levy on a few visa routes, then why didn't they just name those routes in the Act? I missed the amendment to the Act that shows which visa routes will have the NHS levy first, would you put that link please.

All I know is what I've read in the Department of Health document. That is what we are discussing in this thread.

What "always has been" (legal residents can use the NHS for free) and what National means, especially under this Immigration Act 2014, are  different things. It's quite clear from this Act, that it will not remain as it always has been.

Maybe not, but even with the new act, it's still not going to be 'just for UK nationals' - you've said that yourself... it's for people who hold ILR and for EEA nationals as well... are you now going to start making an argument against your own statement?

The Factsheet link you posted earlier, which you quoted from, was dated October 2013. That was 9 months ago.

If you read the Department of Health document, it states which groups of people will be charged and which won't.

It mentions some specific visa types (workers and students), but not all of them, which is what started this discussion about spousal visas in the first post.

It mentions that people with UK citizenship and ILR will not have a levy.

It mentions that EUs will not have a levy.

I quoted parts of this just a few posts ago - did you not read it?

Obviously, though as this won't be implemented until the 2015/016 financial year, there are likely to be more details and specifics to come in the future.

I didn't say there was an amendment to the Immigration Act. I don't know if there has been or not.

I'm just stating what the link in the OP says about the levy fee. That's all I know about it.

All I know is what I've read in the Department of Health document. That is what we are discussing in this thread.

Maybe not, but even with the new act, it's still not going to be 'just for UK nationals' - you've said that yourself... it's for people who hold ILR and for EEA nationals as well... are you now going to start making an argument against your own statement?

Oh, right. The Bill and the Act are different. The Bill would be changed as it passes through the Houses to become law. The Act, is the law.

To set the levy, they need to do something else(?) with regards to this Act. They did say with the Bill, they that intend to make the NHS levy lower than the cost of private insurance. I thought perhaps the levy had been set by law.

I have made it clear from the start that the Act could affect those who weren't a UK national or who hadn't got ILR. I also said that I assumed those on the EU route had different rules.

Although at the time I first mentioned it to you on SOAS Aids topic, I did say that I wasn't sure if it was two separate Bills or just the one. As I recall, you said you hadn't heard of these changes. That was about it until it became law in May.

Disgusting law. I pay NI like everyone else, and the exorbitant visa fees. Why must I pay a nonsensical fee for the NHS that I am already supporting through taxes? So when I renew my FLR M I'll pay twice as much for it? Garbage.

"..ensure that in future every man and woman and child can rely on getting all the advice and treatment and care which they may need in matters of personal health; that what they get shall be the best medical and other facilities available; that their getting these shall not depend on whether they can pay for them, or on any other factor irrelevant to the real need-the real need being to bring the country’s full resources to bear upon reducing ill-health and promoting good health in all its citizens." - from the original White Paper, 1944.

Just for point of reference. The National Health Service was specifically set up not to be provisional upon any individual's ability to pay or history of payment.

I'm all for them cracking down on visitors using the NHS Inappropriately, but charging 125% of the normal cost seems, well, illegal. That sort of thing would absolutely be unconstitutional in the US (the charging extra part, I mean. Not charging for it generally)

Last time my dad was in the hospital (in the US) before he passed away, his hospital charged something like $8 for 2 Tylenols.  Charging well above and beyond is very commonplace in the US.  Remember, in the US, heathcare has become, for better or for worse, a for-profit industry.

But back to the NHS: I recently had an NHS prescription medication for which I paid the NHS prescription charge of £8.05.  This prescription actually costs the NHS only 95p.
Then again, another prescription which I will be starting shortly costs the NHS £32, and I will still pay only the £8.05 prescription charge.  So I guess in the long run I get the better end of the deal - this time at least.  I believe the proper British expression is "swings and roundabouts". 

And to get back to the OP - the link that I initially posted clearly states that students on student visas will be exempt from charges, and student visas are settlement visas (although only temporary ones).  Therefore by extrapolation FLR will also be exempt.  I do agree that it would be ideal if this were spelled out more directly in the government's legalese.

My feel is that the intent of this is a "carrot and stick" approach - a carrot to NHS Trusts who may find it more worth their while if they can charge over and beyond costs to recover fees, and a stick to those who come here with sole intent of abusing the system.  I work in a hospital that is located near the channel ports and believe me we do get them - and as such our Trust has become pretty adept at weeding them out.  However, other Trusts who don't see this as frequently may find that the time and money involved in recovering costs from "NHS Tourists" doesn't gain them anything - but being allowed to charge 150% may make the difference.

And to get back to the OP - the link that I initially posted clearly states that students on student visas will be exempt from charges, and student visas are settlement visas (although only temporary ones).  Therefore by extrapolation FLR will also be exempt.  I do agree that it would be ideal if this were spelled out more directly in the government's legalese.

It very clearly states in your link that student visas will NOT be exempt from charges and that it is expected they will have to pay £150 per year for the NHS surcharge.

Student visas are NOT settlement visas. They do not lead to settlement (you cannot qualify for ILR on a student visa) and are only temporary.

A settlement visa is defined as a visa that has the purpose of eventually gaining settlement (ILR) in the UK.... and the only visas that come under this category are family visas. While work visas can lead to settlement, they are not defined under the settlement visa category, because that is not their primary purpose.

Settlement visas include the following visas only:
fiance visa, spousal visa, civil partner visa, proposed civil partner visa, dependant child of a UK citizen/settled person, adult dependant of a UK citizen, and any other family of a settled person visas.

There is no mention in the document about whether people on temporary settlement visas such as FLR(M) will be exempt, but considering it basically says that people on all temporary visas will have to pay, I would imagine people on FLR(M) will NOT be exempt from paying, just as people on student visas and work visas will have to pay too.

Last time my dad was in the hospital (in the US) before he passed away, his hospital charged something like $8 for 2 Tylenols.  Charging well above and beyond is very commonplace in the US.  Remember, in the US, heathcare has become, for better or for worse, a for-profit industry.

I am not talking about overcharging generally.  I am talking about charging people more than normal simply because of their alienage status.  That is entirely unconstitutional in the US.  It falls under equal protection.  There is no equal protection issue if everyone is charged the same, even if that amount is outrageousHence, why it is not illegal for a hospital to charge you 8 bucks for 2 tylenol.  Now, if a hospital were to charge a citizen 8 bucks and then charge an alien 10 bucks (125% of the normal charge), THAT would be illegal.  That's what I'm referring to: the point in the original BBC article in the first post here where they said that migrants would get charged £125 for a £100 procedure simply because they are migrants.

Edenlynn,

You've still got me mystified about the 'Kenyan' popping over for the new hip and free holiday. First of all, and maybe you know more about it than I, it seems to me being sawn open and bits of bone end removed to be replaced by cement and metal hardly qualifies as a holiday - even if in the long run it relieves pain.

But I am reading that there is a two year wait for these operations....

Was the Kenyan hanging around for that long?

I am not talking about overcharging generally.  I am talking about charging people more than normal simply because of their alienage status.  That is entirely unconstitutional in the US.  It falls under equal protection.  There is no equal protection issue if everyone is charged the same, even if that amount is outrageousHence, why it is not illegal for a hospital to charge you 8 bucks for 2 tylenol.  Now, if a hospital were to charge a citizen 8 bucks and then charge an alien 10 bucks (125% of the normal charge), THAT would be illegal.  That's what I'm referring to: the point in the original BBC article in the first post here where they said that migrants would get charged £125 for a £100 procedure simply because they are migrants.

Whilst I agree that charging different rates is unkind and perhaps unethical, I don't buy your argument that it's unconstitutional. Which particular clause in the Constitution do you believe protects the right of non-Americans to pay the same amount for healthcare as citizens do? The founding fathers would have been prescient indeed to have included such a provision.

Facetiousness aside, though, constitutionality is irrelevant here. Many American hospitals and all insurance companies are privately operated. Private companies will do whatever they like, and charge what the market will bear, and who's to stop them? I would not be at all surprised to learn that insurance companies charge green card holders more than citizens for the same policies, or have different requirements for them, etc.

I've been in the UK for the past six years so know very little about Obamacare. Presumably non-US nationals are also required to have insurance? Is there any control over what kind of policies they can get? Are they the same as for US citizens? Anyone know?

Whilst I agree that charging different rates is unkind and perhaps unethical, I don't buy your argument that it's unconstitutional. Which particular clause in the Constitution do you believe protects the right of non-Americans to pay the same amount for healthcare as citizens do? The founding fathers would have been prescient indeed to have included such a provision.

Facetiousness aside, though, constitutionality is irrelevant here. Many American hospitals and all insurance companies are privately operated. Private companies will do whatever they like, and charge what the market will bear, and who's to stop them? I would not be at all surprised to learn that insurance companies charge green card holders more than citizens for the same policies, or have different requirements for them, etc.

I've been in the UK for the past six years so know very little about Obamacare. Presumably non-US nationals are also required to have insurance? Is there any control over what kind of policies they can get? Are they the same as for US citizens? Anyone know?

I agree with you on the private action part (though there may be some legislation based on the commerce power of congress that would enjoin private hospitals from discriminating that I'm not aware of).  The constitution, with a few exceptions, generally only applies to government action or action that can be attributed to the government.  But there are state hospitals in the US.  For instance, any hospital run by a public university, will have to comply with the constitution.  

And it falls under the equal protection clause of the 14th amendment.  The supreme court has held that national origin/alienage is a suspect class akin to discriminating on the basis of race.  In fact, it gets even higher scrutiny from the court than gender discrimination.  National origin/alienage and race are the only 2 that receive strict scrutiny, while gender receives intermediate scrutiny.  National origin classifications generally receive strict scrutiny (government has the burden to show that the clssification is necessary to achieve a compelling government purpose), except for some very narrow circumstances, like certain employment that has to do with actual democratic process (public school teachers, law enforcement, public office).  So yes, it would very much be unconstitutional.  By the way, I'm not just shooting from the hip here, I just graduated from law school and I'm taking the bar exam in a mere week and half.  I spent three years studying law and had an entire year devoted to constitutional law, not to mention the intense studying I'm doing now.

I have no idea about obamacare, it's not something I've studied in depth with regard to any requirements it places on non-permanent residents.

ETA: I'm not really sure if you were being sarcastic in you first paragraph, but I answered the query anyway.

I got to thinking about it and realized that the Civil Rights act of 1994, which has all of the provisions applying to workplace, restaurant, hotel, and  educational discrimination likely has a provision relating to health care.  And it does.

It bans discrimination on the basis of race and notional origin, among other things, in any health care facility that receives any federal money.  Which is likely most, if not all hospitals.  42 USC §2000d and 45 CFR §80.1

I think that if Applebee's charged an immigrant more for their spicy chicken wrap all hell would erupt - and I am sure some sort of legal action would follow almost immediately. And while I am not a lawyer, I can almost assure you of the outcome.

But this idea of say insurance premiums or lending practices....I think there has been a lot of legal stuff going on in the US for quite a while about that sort of thing. Right wingers swear that the on-going financial crisis was caused by enforced equal treatment in lending (almost every serious economist refutes).

I find this idea of the Founding Fathers very strange. I suppose they were really bright guys. They did say black people were only worth half a white man - and I am not sure they thought women counted as human at all, but they did some how manage to cobble enough vague stuff together to keep us from mass slaughter for 70 years (well aside from Native genocide).

It is odd that we are always trying to figure out what the Founding Fathers meant - what their true intentions were, when we have almost all of their correspondence archived. For instance we know that George Washington was not so much worried about grand concepts of freedom and justice as he was about London merchants  sending him slightly shoddy goods and charging him too much. He goes on and on about it. He was very particular about the stitching in his jackets.

I think that if Applebee's charged an immigrant more for their spicy chicken wrap all hell would erupt - and I am sure some sort of legal action would follow almost immediately. And while I am not a lawyer, I can almost assure you of the outcome.
 

A co-worker told me that, in the example I gave him, if he were to be charged more sales tax in the US based solely on his being a foreigner, that he wouldn't think much of it as "if that's what the rules are, that's what they are, they can make it what they want and it is what it is". It made my head hurt. I told him that that was a cop-out.

It very clearly states in your link that student visas will NOT be exempt from charges and that it is expected they will have to pay £150 per year for the NHS surcharge.

The link I posted in my OP (which is the 2nd post in this thread) links to two pdf documents, the first of which is called "Visitor and Migrant Cost Recovery Plan".  I admit I have not had time to read all of this.  But Annex B clearly describes different scenarios.  Pages 62 and 63 CLEARLY state that, as is currently the case, a student on a valid student visa will be covered for treatment on the NHS.
However, I have only just now noticed that under the new system the student will need to have paid the £450 surcharge before this is the case.  So on this I do stand corrected!

As you yourself has stated student visas don't normally lead to permanent settlement, as is the case with FLR.  And I do wish that the document was more descriptive on this.

Thanks all for your help! SO my wife should not be affected at all? How about when she applys for ILR next year, will she have to pay the levy on top if the visa fee do you know?

I've just been flicking around the internet and it seems this won't come in until March 2015. Secondary Legislation, that sets the levy (I bet it's divisible by 12) and which groups they are starting with first of all, is expected this Autumn.

We have been trying to conceive but no success, so were thinking of looking into fertility treatment but it concerns me that we would get a Bill try and get fertility treatment on the NHS even if we had to pay a levy charge? as it would be considered expensive discretionary treatment? either now or after she gets her ILR?

Looking on the consultation the government ran a year ago on the changes to the NHS, IVF was one of the examples they gave which they did not want someone on the NHS levy to have for free, until they had permanent residence. Cosmetic surgery was the other they mentioned. What they actually decide, we won't know until later this year it seems.