Abstract Background Health policy research tends to focus on medical care practices and disease prevention while the emphasis on political determinants of health is thin at best. Within this case study, we look at Austria's Freedom Party (FPÖ), a Populist Radical Right (PRR) party, and their impact on health policies. Existing conceptualizations suggest three key dimensions of PRR parties: People centrism (nativism), vertical exclusion (ant-political elite), and horizontal exclusion (immigrants). We explore how these conceptualizations are applicable to the health policy choices of the FPÖ. Methods We conducted a review of available primary sources (legal and policy documents) and secondary literature (academic, press, and think-tank publications). Resulting data were analysed thematically. Results In the years 2000 to 2003 and 2017 to 2019, the FPÖ, in a coalition government with the ÖVP, was in charge of the health ministry. The biggest changes came about in 2017 where 1) the FPÖ reneged on the smoking ban set to have been implemented in May 2018. 2) the FPÖ led the consolidation of the 21 separate health insurance companies to five, stating that it would bring patients €1 billion. However, the current government is now confronted with a budget deficit of the ÖGK. 3) the FPÖ promoted social policies reducing the social benefits for immigrants who showed insufficient language skills. Conclusions The case analysis suggests that the FPÖ's health policy choices, described above, may be explained through the people centrist, nativist, and anti-elitist tendencies of PRR parties. 1) reneging on the smoking ban can be interpreted as an anti-scientific and pro “ordinary citizen” action. 2) the health insurance mergers, can be explained as being a strike against the economic and political elites, who allegedly used the complex structure for their own benefit (clientelism). 3) attacking the socio-economic status of immigrants, a social determinant of general health.