Why does undocumented immigrants' access to healthcare beyond urgent treatment differ across the territory of the same state? Through a comparison of Italian regions and Spanish autonomous communities, this paper contends that traditions of regional citizenship concerning the protection of vulnerable subjects shape policy choices in significant ways. Left-wing regional governments use traditions as building blocks that enable the protection of healthcare for undocumented immigrants, while

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... wing regional governments invoke traditions to delegate intervention to civil society actors. By activating traditions of regional citizenship for different purposes, subnational governments define distinctive preferences concerning migration, healthcare and welfare.