New French government questions health provision for migrants
Some ministers in the new government lineup of French Prime Minister Michel Barnier are talking about possibly abolishing the state medical aid for undocumented migrants, which healthcare professionals say would further weaken the French system.
Almost a year after the Immigration Act was passed, the state medical aid scheme known as AME is once again at the heart of the debate.
A few hours after announcing the composition of his government, Barnier said on TV broadcaster France 2 on Sunday (22 September) that he had had ‘no taboos’ about abolishing access to healthcare currently offered to undocumented migrants who have been in France for over three months.
But Agnès Pannier-Runacher, whom Barnier reappointed as France’s ecological transition, climate and risk prevention minister for a second time, is against “abolishing” the AME.
However, the newly appointed Home Affairs Minister, Bruno Retailleau, said he favoured transforming the scheme into some sort of emergency medical aid, which would be drastically reduced compared to the current AME.
Known for his tough stance on immigration, Retailleau, also a former chairman of the Les Républicains (LR) group in the Senate, had already spoken out against the AME when the Immigration Act was passed last November.
“We have a problem because we are one of the European countries that gives the most benefits. I don’t want France to stand out. I don’t want France to be the most attractive country in Europe for a certain number of social benefits and access to healthcare,” he said in an interview on TF1 on Monday (23 September).
However, according to Ophélie Marrel, legal adviser to the French National Consultative Commission on Human Rights (CNCDH), access to social benefits is not the main motivation for migrants to come to France, as is often claimed by the right and the far right.
“It’s simply not true,” said Marrel, with figures to back her up. “Of all the people who could have access to the AME, only 50% benefit from it’,” she told Euractiv.
The main reasons for this are complex administrative procedures and migrants lacking access to information about the scheme.
Abolishing the AME, but at what cost?
Also high on Barnier’s list of priorities is the fight against those who take advantage of social benefits such as the AME.
Covered by the health insurance system, the AME scheme cost the state a total of €1.14 billion in 2023 or 0.5% of total healthcare expenditure in France, a recent Senate report reads.
“In terms of public health, the AME plays an essential role. It covers day-to-day care as part of a preventive approach. If we abolish it, people will turn instead to emergency and hospital care,” said Marrel about a healthcare sector that is already largely crisis-bound.
Abolishing the scheme would also affect many, as the number of those benefitting from AME has increased by 43% between 2019 and 2023, with 423,000 benefitting that year.
In other words, not only will healthcare be more expensive for undocumented migrants, but emergency departments and hospitals could be overrun, thus further putting pressure on the system.
Health professionals express opposition
Health professionals have already expressed their opposition to the possible abolition of the AME scheme.
In an opinion piece published on 11 November 2023, as the debate on the Immigration Bill was in full swing, 3,500 doctors pledged to “disobey” and “continue to provide free care” to patients who would normally benefit from the AME if it was abolished.
On Monday, the inter-hospital collective sent a letter to the new health minister, Geneviève Darrieussecq, asking her to take “strong and concrete measures without delay, in opposition to this ineffective and demagogic proposal.”
This follows the tabling of a bill in the National Assembly on 17 September by MPs from the ‘Republican Right’ group – of which Les Républicains is a member – to amend the provisions on access to healthcare for irregular migrants.
Although Darrieussecq has yet to comment on the AME, there is no doubt that she will not be able to remain silent for long.
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