The right has promised not to vote on the immigration bill if the regularization of undocumented workers in “professions in tension” is maintained. But it also requires a reform of state medical aid, which divides the executive.
Repeatedly postponed, criticized on the left and right and contested by associations defending exiles… The immigration bill arrives in the Senate, Monday, November 6, with flammable debates in perspective.
The main sticking point concerns article 3 of the text, which provides for the regularization of undocumented workers in “jobs in shortage”. The right made one “Red line”, while the majority is divided on the need to keep it. But discussions also promise to be heated on the transformation of state medical aid (AME) into “emergency medical aid”.
The government’s bill initially did not provide for a reform of this aid, which offers coverage of health costs to illegal foreigners present in France for at least three months and with very low income. But the text, amended by the Senate Law Committee, controlled by the right, now plans to limit the AME care basket to “treatment of serious illnesses and acute pain”to “regulatory vaccinations” and to “pregnancy-related care”.
The right sees it as a “breathtaking” for immigration
Historical target of the right and the extreme right since its creation in 2000, the AME is regularly accused by its detractors of costing “too expensive” – approximately 1.2 billion euros annually for 400,000 beneficiaries, or 0.5% of Health Insurance expenditure. “I have observed that over the past 10 years, (…) there has been a doubling of the cost, which is well over a billion.”notes the president of the LR group in the Senate, Bruno Retailleau, to Public Senate.
The right and the extreme right also accuse the AME of generating a “air call” for illegal immigration. Moreover, “the AME gives access to a basket of care which is almost that of the residents” French, laments the president of the LR group in the Senate, Bruno Retailleau, to Public Senate.
A report (PDF document) of the General Inspectorate of Finance and the General Inspectorate of Social Affairs recalled in 2019 that offering a minimum level of care to foreigners in an irregular situation was obligatory, in particular because of France’s international commitments. But this report also underlined that the AME was “one of the [systèmes] most generous in the European Union.
However, the report advised “to consider with caution any evolution of the AME (…), in particular a further reduction in the basket of care”. He considered that the latter solution presented “significant risks to health public. And also that she could be “counterproductive from a perspective of efficiency of public spending”A “delay in care leading to a worsening of the state of health”or, ultimately, “to more expensive care”.
Divided government
On the government side, it’s the big gap. Looking for months for a compromise with the right, the Minister of the Interior, Gérald Darmanin, said in The Parisian favorable “personally” to the idea of restricting the AMEattracting the wrath of part of the executive.
Olivier Véran, the government spokesperson and doctor, for his part assumed “a real disagreement” with the Minister of the Interior, defending the current system. Hearing in the Senate, the Minister of Health, Aurélien Rousseau, also defended a “public health device”the deletion of which could result in “the dumping on the hospital of all urgent care” and the “diffusion” infectious diseases such as tuberculosis. A position shared by the medical profession: at the beginning of November, more than 3,000 caregivers, including Nobel Prize winner in medicine Françoise Barré-Sinoussi, took action via a platform in The world to defend the AME.
A pre-report to decide
To decide the position of the executive, the Prime Minister, Elisabeth Borne, entrusted a mission to examine the system to two political veterans with opposing profiles: Patrick Stéfanini, from the right and specialist in immigration issues, and Claude Evin, former Minister of Social Affairs from the PS. “The government’s position will of course result from the conclusions”she assured, asking “everyone” of “pull in the same direction”.
If the final report is expected on December 2, a pre-report was submitted Thursday, November 2 to Matignon. “The AME is not a factor of attractiveness”, believe the two signatories, report The echoes. They are also firmly opposed to making a distinction between urgent and non-urgent care, which doctors themselves sometimes struggle to make. The authors of the pre-report, on the other hand, propose adaptations to the AME, such as its time limitation, believing that aid that is too long can encourage people to remain underground.
Beyond the substantive arguments, part of the majority could want to give in to LR in order to ensure their vote, avoiding, in doing so, a new adoption of a text without a vote via the use of article 49.3.