Federal Supreme Court, Decision 9C_574/2021, 9C_575/2021 from 21 June 2022

21 July 2022 – In the present decision, the Federal Supreme Court (hereinafter the Court) had to assess whether the complainant, who had Lithuanian nationality, was subject to compulsory health insurance in Switzerland.

The complainant was an inmate of a detention centre in Switzerland. It was thus undisputed that he had been subject to Swiss law regarding social security issues since his arrest. The complainant demanded to be insured under compulsory health insurance, referring to the basic principle of equal opportunities in health care, the prohibition of discrimination and the principle of equal treatment. However, the Federal Supreme Court ruled that the central connecting factor for the creation of the insurance obligation according to Art. 3 para. 1 of the Swiss Federal Law on Health Insurance (Bundesgesetz über die Krankenversicherung, KVG) is the place of residence in Switzerland. This is also a condition insofar as persons without such residence, even Swiss nationals, cannot in principle join the compulsory insurance scheme. Exceptions to this rule, namely the refugees specifically taken up by the complainants (cf. Art. 1 para. 2 lit. c Health Insurance Ordinance (Verordnung über die Krankenversicherung, KVV)), must be expressly provided for in the KVV or state treaties. The complainant did not have a residence in Switzerland, nor was there an alternative connecting factor. He was therefore not covered by the compulsory health insurance. This would not have changed if it had been assumed with the complainants that detainees were entitled to basic medical care according to the KVG catalogue of services and that these standards were sometimes undercut in a discriminatory manner.

Therefore, the Court dismissed the appeal.

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