30 June 2026 | The preliminary draft agreements currently under consideration by Parliament for the attribution of additional forms and particular conditions of autonomy to the Regions of Veneto, Lombardy, Piedmont and Liguria constitute the first application of the procedures established by Law No. 86/2024, following the constitutional constraints and the constitutionally compliant interpretation set out in Constitutional Court Judgment No. 192 of 2024.
The draft agreements concern two distinct groups of functions. The first relates to certain areas in which Law No. 86/2024 did not require the prior determination of the Essential Levels of Services (LEPs) concerning civil and social rights to be guaranteed uniformly throughout the national territory. Specifically, these areas are civil protection, regulated professions, and supplementary and complementary pension schemes. The second concerns healthcare, jointly with the coordination of public finances.
The draft agreements are accompanied by extensive supporting documentation intended to justify the Regions’ requests, explain the content of the agreements, assess their consistency with the principle of subsidiarity, and verify both the absence of new or additional burdens on public finances and the preservation of financial neutrality for Regions that are not parties to the agreements.
Despite the substantial amount of information provided, the documentation only partially addresses the requirement emphasized by the Constitutional Court that the transfer of functions be justified by specific reference to both the characteristics of the functions concerned and the particular social, administrative, geographical, economic, demographic, financial and geopolitical context of each requesting Region. According to the Court, the expected benefits in terms of effectiveness, efficiency, equity and accountability should be demonstrated through analyses based on shared, transparent and, wherever possible, scientifically validated methodologies.
In most cases, the justifications advanced by the Regions amount to general statements of expected benefits. For example, they argue that greater proximity to citizens could improve the responsiveness of public policies to local needs and enhance the timeliness of administrative action. However, the documentation does not provide indicators capable of assessing the magnitude of the expected benefits arising from greater autonomy. Nor does it adequately explain why the specific characteristics of the requesting Regions would justify the transfer of the functions concerned or enable the expected benefits to be achieved.
The preliminary draft agreements contain identical provisions for all four Regions. This uniformity raises important questions. Where the requests are identical across Regions accounting for more than 40 per cent of the population of Italy’s ordinary-statute Regions, it is legitimate to ask whether the underlying needs are in fact common to the regional system as a whole and could therefore be addressed within the framework of symmetrical regionalism, rather than through differentiated autonomy.
Two additional considerations deserve attention.
First, it is not always clear whether, or to what extent, the functions set out in the draft agreements actually expand regional autonomy. The numerous references to existing legislation often appear to confine the Regions’ powers to those already available to all ordinary-statute Regions under current law. Moreover, recent legislative measures have, in several cases, already broadened the scope for autonomous regional action. The agreements could nevertheless encourage a more extensive use of these powers, not only by the Regions signing the agreements but also by the other ordinary-statute Regions. To prevent the emergence of inefficient competitive dynamics—particularly in the healthcare sector, where they could exacerbate existing territorial disparities—it will be essential to ensure that appropriate mechanisms are in place to support those Regions facing greater difficulties in guaranteeing the Essential Levels of Care (LEAs) and in recruiting the healthcare professionals they require.
Second, there appears to be a significant gap between the expectations expressed by the Regions during the initial stage of the negotiations and in the supporting documentation, on the one hand, and the additional powers that the draft agreements actually appear to confer, on the other. This discrepancy could give rise to divergent interpretations by the State and the Regions that conclude the agreements, thereby creating legal uncertainty and increasing the risk of constitutional litigation.
From a financial perspective, the most significant feature of the draft agreements is the absence of any assignment of shares in central government tax revenues to the Regions requesting greater autonomy. This reflects the fact that the transfer of the functions covered by the preliminary agreements does not generate savings for the central government in terms of either human or material resources.
Any additional costs arising from the exercise of the transferred functions will therefore have to be financed by the regional budgets. For certain functions—notably civil protection—additional resources have recently been allocated to all ordinary-statute Regions. In other cases, however, the Regions will need to identify the necessary funding within their own budgets, potentially through increases in regional taxation or reductions in expenditure.
The draft agreements include financial neutrality clauses and other safeguards, particularly in the healthcare sector, designed to ensure that the exercise of the additional powers does not have financial implications for either the State or the other Regions. This includes preventing any changes to the criteria governing the allocation of central government transfers or any effects on interregional patient mobility. Nevertheless, indirect effects on the State budget could arise if the agreements encourage wider use of supplementary health insurance schemes and supplementary pension schemes, both of which benefit from favourable tax treatment.
The evolution of the fiscal cost of these tax incentives should therefore be carefully monitored, as should any acceleration in healthcare expenditure resulting from the relaxation of earmarking requirements for healthcare funding. There is also a risk that inefficient competitive dynamics could emerge in the healthcare sector, leading, among other effects, to an increase in interregional patient mobility and a widening of existing territorial disparities. Appropriate mechanisms should therefore be put in place to support those Regions experiencing greater difficulties in ensuring the provision of the LEAs.
As noted above, many of the powers provided for in the preliminary agreements are already available under ordinary legislation to all ordinary-statute Regions, provided that they continue to comply with balanced-budget requirements. It should be recalled, however, that fiscal capacity varies substantially across Regions, and with it the effective scope for exercising these powers.
The existence of these asymmetries reinforces the Constitutional Court’s strong call for the completion of Italy’s fiscal federalism framework. This would require the reorganisation of territorial taxation pursuant to the fiscal reform enabling legislation, the replacement of the remaining State transfers in areas of regional competence with own-source revenues, and the establishment of the equalisation fund provided for by Legislative Decree No. 68/2011.
The hearing is organised as follows. It first retraces the process that led to the presentation of the preliminary draft agreements, highlighting the significance of the Constitutional Court’s judgment on the legislation governing differentiated regional autonomy (Section 2). It then analyses the draft agreements as a whole (Section 3), with particular attention to the potential financial implications of the transfer of functions (Section 3.1). Finally, it examines the requests relating to the individual functions (Section 4), focusing in particular on supplementary and complementary pension schemes (Section 4.1) and on healthcare and the coordination of public finances (Section 4.2).