New Zealand Tightens Health Rules for Disabled Migrants: What It Means for Applicants.

From 17 March 2025, dependent children of work, student, or military visa holders will not be eligible for student or visitor visas if they have a severe cognitive or developmental disability that requires significant support.

The primary reason for these changes is to align the health requirements for dependent children of temporary visa holders with those for residence class visas, ensuring consistency in the immigration system. The announcement states "The government aims to balance facilitating entry for individuals New Zealand needs while managing costs and demands on the health and education systems."

What’s the background to this change?

Currently, the government has not released briefing papers on this topic, so we rely on insights from 20 years of experience working at the coalface of immigration policy.

The starting point is that all migrants to New Zealand must meet "acceptable health" standards. There are two tests: one for temporary entry, which focuses on the duration of intended stay, and one for residence, where the lens can be indefinitely into the future.

As things have stood, if a child qualifies for the Ongoing Resourcing Scheme (ORS) funding, they are automatically deemed not to meet New Zealand’s health requirements for either temporary entry or residence. Temporary entry instructions were otherwise silent on the issue of "disability", whereas the residence instructions already had the following on a deemed "blacklist":

Severe developmental disorders or severe cognitive impairments where significant support is required, including but not exclusive to:

• physical disability

• intellectual disability

• autistic spectrum disorders

• brain injury

What's happened is that under the changes, the latter listing is now replicated in the temporary entry instructions and the lens is long: in other words, they are not just looking at the length of the intended stay.

For residence applicants, it is possible to seek a health "waiver," as long as the applicant does not fall into an unwaiverable category. Unwaiverable categories include those who need full-time care. For those temporary visa applicants now found to fall within the exclusion, a waiver will also now be at least considered (though waivers are given out extremely sparingly, in exceptional cases e.g. child of brain surgeon.

When consulting with migrants about their visa eligibility, we ask detailed questions about their physical, mental, and developmental health. As seen globally, we are encountering more cases involving adults and children with various mental health and neurodevelopmental diagnoses, such as ADHD or autism. Advising on health conditions can be challenging—not only because of the emotional responses it can trigger, but also due to the complexity of applying policies to individual circumstances. We rely on specialist health reports, with the ultimate decision-maker being an Immigration New Zealand-contracted GP, acting as a Medical Assessor.

Migrants often ask whether, if they are found not to be in "acceptable health," they can simply cover their own healthcare costs. The answer is no. New Zealand’s policies specifically prohibit consideration of privately funded healthcare because once on a qualifying visa, migrants become eligible for state-funded healthcare. Additionally, it’s not just about costs; policies are concerned with the impact on the system, which may already be under strain. For instance, a cancer patient might find that a rejection letter references both costs and the significant pressure on the specific service they require.

We often have to soften difficult advice by explaining that while New Zealand is an inclusive country, we are protective of our state health system. Kiwis are well aware of the pressure it’s under. This chart illustrates how our per capita expenditure has been increasing over the years.

The issue of discrimination

The Green Party has raised concerns about whether our immigration health requirements are discriminatory. In a press release titled "Government Tramples On The Rights Of Disabled Migrant Children," they argue that “Disability should not be a barrier for migrant families wanting to come to Aotearoa and call it home. Stopping migrant families from coming here because they have a disabled child would be a national shame and completely undermine our credibility on the global stage when it comes to human rights." The Greens also point out that in 2022, the United Nations Committee on the Rights of Persons with Disabilities (CRPD) identified our immigration health policies as a concern, citing discrimination against disabled people and calling for their abolition.

On Facebook, Migrants Against the Acceptable Standard of Health Aotearoa )"MAASHD") page has 632 followers. Their hashtag is #ENDASHNOW. Maasha has issued a UNCRPD "Shadow Report" which gives several https://docs.google.com/document/d/e/2PACX-1vR0kelplYL8PP3rv3Dl3VrKjAznEI39BvRJbz070GeV2unIqfaD1QdVUyoaa_2pbsIxUmNBw-7MzN3T/pub

They make a compelling case. But what is the right approach here? New Zealand screens not just for disability, but for a range of conditions due to concerns about the welfare state health system. All New Zealanders are entitled to free or heavily subsidised healthcare, as is the case for work visa holders and their dependents if the visa duration is two years or more. Other countries have different approaches. For example, the UK requires temporary visa holders to pay an annual health surcharge, while Australia mandates most temporary migrants to either hold medical insurance or meet their own medical costs. In Canada, healthcare for temporary workers is determined at the state level, and most states do not cover temporary workers under Medicare. In the USA, most temporary migrants are not eligible for publicly funded healthcare.

The intent behind the changes

The purpose of this new tightening of health requirements seems to be to avoid situations where families are allowed into New Zealand under temporary entry screening, only to be denied residency later on. A recent case at the Immigration & Protection Tribunal highlights the risks of moving to New Zealand on temporary visas when a family member has a long-term condition.

In that case, a couple with three children moved to New Zealand in February 2020. The mother was a schoolteacher. When they applied for residence in 2022, their 7-year-old son, who had Lennox-Gastaut syndrome (a severe form of epilepsy) and global developmental delay, was found to be eligible for ORS funding and likely required significant specialist intervention to support his learning at school. Immigration New Zealand rejected their application, stating that the child did not meet the health requirements and was ineligible for a waiver due to needing full-time care.

The Immigration Tribunal found in favor of the family due to special circumstances, including the mother’s 20 years of teaching experience and strong local references, such as from the local rugby club (!). However, the Tribunal only has the authority to recommend that the Associate Minister of Immigration grant residence as an exception. In November 2024, the Minister decided to decline their appeal. Interestingly, the child in question was likely only 2 years old when the family first arrived in New Zealand and passed the temporary entry health requirements. While he had begun suffering seizures at 6 months, he was reportedly seizure-free between December 2019 and May 2020, possibly allowing him to meet the temporary entry health requirements at the time.

The question is: would the new health requirements change the outcome for this child starting from 17 March 2025? As much as one tries to prevent this sort of situation arising, there will be case where a child's condition is perhaps not known at the outset. Or it could be that a child is born only after a family moves here. I have long since felt that in the case of children born in New Zealand or a condition that develops while someone is here on a temporary visa should be waivered as the consequences to those affected are usually devastating. As to whether we should all align ourselves with the Greens and CRPD is a matter for careful consideration in light of the competing interests of individuals versus a strained state funded healthcare system.

How do the Five Eyes countries compare?

When comparing the health policies of the Five Eyes countries, we see a similar approach to screening for conditions that may place a heavy burden on state systems. The CRPD has expressed concerns about these policies, and New Zealand’s specific inclusion of "severe cognitive or developmental disability that requires significant support" as not meeting health requirements makes us stand out as potentially the most discriminatory.

Canada has done its part (in 2022) to review its medical inadmissability rules to better align their medical inadmissibility policy with Canadian values on diversity and the inclusion of people with disabilities. They said the changes "strike a balance between welcoming newcomers into Canadian society through a fair and compassionate immigration system, while also protecting publicly funded health and social services." The question is: should New Zealand head in the same direction? If we don't screen for "disability", then what about long-term illness? Is it also discriminatory to be concerned about the healthcare implications for those people? Where should we draw the lines? I'm sure this issue will continue to be controversial, particularly as more and more children are diagnosed with conditions such as autism. Arguments will no doubt continue as to what constitutes "severe" and needing "significant support" given these terms are not defined, at least transparently. Plus we see many cases where there are diagnoses made overseas which may be dealt with differently in New Zealand. Here at Into NZ, we do have considerable experience in dealing with complex health cases, so if this affects you or your child, we are always here to provide the practical and realistic advice you need.

Katy Armstrong

Licensed Immigration Adviser #200800243