Politics: The government wants to restrict state medical aid for undocumented immigrants

Six days before the perilous vote of confidence requested by François Bayrou , the government has put on the table an issue dear to the right and the far right by proposing to review the care covered by the State Medical Aid (AME) intended for undocumented foreigners. According to draft decrees consulted Tuesday by AFP, the government is considering in particular reviewing the conditions of access and resources to benefit from the AME and reducing the list of health care covered by this system intended for foreigners in an irregular situation. The future of these provisions remains very uncertain at this stage due to the probable fall of the Prime Minister on Monday.

The Ministry of Health assured that "the proposed measures do not in any way call into question the AME system, but constitute adjustments in line with the recommendations of the Evin-Stéfanini report." At the end of 2023, this report, commissioned from former Socialist minister Claude Evin and senior LR official Patrick Stefanini in 2023, had generally defended the AME. While recommending some adjustments, particularly concerning the list of benefits that should no longer be automatically granted or the consideration of the resources of the applicant's entire household to access it.

Reforming the AME is a hobbyhorse of both the National Rally, whose leaders called for an "ultra-rapid dissolution" on Tuesday after being received at Matignon, and of the Minister of the Interior, the leader of the Republicans Bruno Retailleau .

State Medical Aid (AME) allows illegal immigrants with very low incomes to have 10% coverage for their medical care. While it is in the crosshairs of the far right and the right, the health world firmly defends it in the name of public health. In 2024, AME represented a state expenditure of €1.2 billion, which represents approximately 0.5% of the health expenditure planned in the Social Security budget (PLFSS).

In detail, with these new decrees submitted Tuesday for review to the National Health Insurance Fund (CNAM) board, the government intends in particular to exclude balneotherapy from the basket of care covered by AME. It also wants to "submit to prior approval" certain treatments currently accessible without this condition after nine months of presence in the country: certain massage and physiotherapy procedures, glasses, hearing aids, dental prosthetics, and medical transport for non-urgent scheduled care in the city, the ministry indicates.

Another decree aims to revise the supporting documents constituting the AME application file. According to the ministry, "the presentation of identity documents including a photograph" would be required. The government intends to "take into account the income of household members in assessing the resource condition" for eligibility for AME. Currently, services only consider the resources of the applicant's dependents, according to the government. When an AME applicant has a spouse or partner who is legally resident, the latter's resources would now be taken into account, the same source specifies.

Socialist Party leader Olivier Faure criticized the LCI channel for "nods to the far right" and said François Bayrou was trying "to save his own neck at all costs." Boris Vallaud, leader of the Socialist Party (PS) deputies, denounced "a democratic scandal, a health folly, a republican betrayal" on X. Manon Aubry, a LFI MEP, accused the Prime Minister on the same channel of "responding to the racist obsessions of the National Rally," "in total disregard of the opinion of the medical community."

"After attacking the unemployed and the sick, we're now attacking immigrants," lashed Dominique Corona, deputy secretary general of the UNSA (Union for Social Security) and a member of the Cnam's board of directors. According to him, the Cnam is due to give its opinion to the committee next Tuesday, the day after the confidence vote, but the unions, opposed to these draft decrees, want them to be examined by the board of directors two days later.