State medical aid is a “generally controlled” system but which “deserves to be adapted”, according to a report

A report written by former PS minister Claude Evin and former LR prefect Patrick Stefanini estimates that expenses linked to State Medical Aid are “generally under control”, but proposes “adaptations”.

A “useful health device” but “necessarily perfectible”. State Medical Aid (AME) for undocumented foreigners, called into question by senators within the framework of the immigration bill, is “generally controlled” but “deserves to be adapted”according to a report submitted to the government on Monday, December 4.

The AME, regularly targeted by the right and the extreme right who accuse it of costing “too expensive” (968 million euros in 2022 for 411,364 beneficiaries), is a system “generally controlled” according to the authors of the report, former PS minister Claude Evin and former prefect Patrick Stefanini.

The two authors do not note “no consumption of care revealing atypicalities, abuse or structural fraud”. Average quarterly consumption per person “remained stable despite the increase in the cost of care”, “from 642 euros in 2009 to 604 euros in 2022”observe the authors of the report.

The number of beneficiaries is increasing, but this increase is linked to the increase in the number of illegal foreigners, and not to a slippage in the system, the report indicates. As part of the “immigration” bill currently being examined by Parliament, the Senate removed the AME to replace it with more restrictive Emergency Medical Aid, but this change would result in “a general complexity” of the system according to the report, in particular to assess what falls under urgent care and what does not.

“This has no place in the immigration bill”

The two rapporteurs nevertheless list a series “adaptations” possible. Claude Evin and Patrick Stefanini notably propose “withdraw the right to AME” to “persons subject to removal orders for reasons of public order”. A status which concerned 13,132 people in 2022, according to the text.

The authors also recommend tightening certain “eligibility criteria”. Currently, the AME is accessible to foreigners in an irregular situation who have been in France for at least three months under resource conditions, but also to their children, spouses or partners. This “title holder status” could be reserved “to minor children only”, the other members must then submit their own request, consider. also to take into account “the resources of the entire household” for admission.

They also propose expanding the list of benefits which would no longer be delivered automatically but only after an agreement with Health Insurance, and suggest some adaptations to combat “non-recourse”, such as the organization of a health check upon arrival on the territory. According to available data, some 50% of potential beneficiaries do not request the AME.

“There are proposals (…) that we will study very quickly”declared Minister of Health Aurélien Rousseau on Monday during a visit to Remiremont hospital (Vosges). “But this has no place in the immigration bill: it is not an immigration subject, but a public health subject”added the minister.

LR MP Véronique Louwagie, supporter of the AMU, regretted “the unfinished nature of certain avenues of proposals” rapporteurs. The immigration bill will be examined by the National Assembly from December 11.