WILLEMSTAD – Thanks to a centuries-old friendship treaty between the Netherlands and the United States, U.S. citizens can relatively easily settle in Curaçao and automatically gain access to the Basic Health Insurance (BVZ). However, legal expert Jeff Sybesma and economist Rob van den Bergh warn that this arrangement, which was never anticipated by lawmakers, could become a financial burden for the healthcare system. 

Same Residency Rights 

The Treaty of Friendship, Commerce, and Navigation of 1956, which replaced the U.S.-Netherlands treaty from 1782, grants American citizens the same residency rights as Dutch nationals born outside of Curaçao. The Joint Court of Justice confirmed in 2014 and 2024 that Americans do not need a residence permit to live in Curaçao. Since the BVZ covers all residents who do not require a residence permit, Americans are automatically included in the program. 

For retired Americans, this arrangement can be financially advantageous. In the U.S., private health insurance premiums for people over 60 can reach up to $20,000 to $40,000 per year, while the premium for BVZ in Curaçao is capped at 6.5% of taxable income, with a maximum of 150,000 guilders for those aged 65 and over. 

Potential Financial Strain 

Wealthy migrants can further reduce their taxable income through fiscal planning, such as taking advantage of the "pensionado" program, which allows for lower contributions to the BVZ fund. However, their healthcare costs could be high due to age and health conditions, while their contributions to the system remain relatively low. 

Although the registered American population in Curaçao is small—264 people in 2023—the number is steadily growing. This benefit is not exclusive to Americans; non-Curaçaoan Dutch nationals are also automatically granted residence and insurance. In both cases, the influx of older migrants could strain the BVZ fund. 

Sybesma and Van den Bergh argue that when the BVZ was introduced in 2013, the impact of the treaty was not taken into account. They question whether the law needs to be amended to prevent unforeseen consequences like this. 

The treaty also applies to other countries within the Kingdom of the Netherlands—Aruba, Sint Maarten, and the BES islands—meaning this issue is relevant across the entire Kingdom.