the AME is “generally controlled”, but “deserves to be adapted”, according to a report

State Medical Assistance (AME) for undocumented foreigners, recently called into question by the Senate in the immigration bill, is “generally controlled“, but “deserves to be adapted», According to the report submitted Monday December 4 to the government by Claude Évin and Patrick Stefanini.

The government, which wants to gather a majority in the National Assembly for its bill on immigration, immediately opened the door to a resumption of certain measures proposed by former PS minister Claude Évin and the prefect and figure of LR Patrick Stefanini. But in a future specific text.

“No proposal relating to the AME can be integrated into the immigration bill currently under examination, these provisions being unrelated to the subject of the text», judge in a press release the three ministers concerned, Gérald Darmanin (Interior) and the tandem Aurélien Rousseau and Agnès Firmin Le Bodo (Health). The AME is regularly targeted by the right, who accuse it of generating a “call of air» for illegal immigration and to cost «too expensive» – 968 million euros in 2022 for 411,364 beneficiaries.

For Claude Évin and Patrick Stefanini, however, the AME “is a useful sanitary device“, “generally controlled” And “which does not generate care consumption revealing atypicalities, abuse or structural fraud“. 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.

Average quarterly consumption per personremained 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.

“Adaptations”

For them, the creation proposed by the Senate of a more restrictive emergency medical aid would lead to “a general complexity“, in particular to assess what constitutes urgent care and what does not. The two rapporteurs nevertheless list a series “adaptations» possible. They propose in particular to “withdraw the right to AME” to “people subject to removal orders for reasons of public order“.

In 2022, 134,280 obligations to leave French territory were issued by the prefectures, including 13,132 for reasons of public order, the report specifies. Some 344 expulsion orders were also issued due to a “threat» to public order, as well as 2051 sentences of ban from French territory following crimes and misdemeanors.

The authors also recommend tightening certain “eligibility criteria“. Currently, the AME is accessible to foreigners in an irregular situation present in France for at least three months – subject to conditions of resources lower than the ceiling of 809.90 euros per month – but also to their children, spouses or cohabitees.

This “status of beneficiary» could be reserved «to minor children only“, the other members must then submit their own request, they believe, also suggesting to take into account “resources of the entire household» for admission to AME.

Divergences

Claude Évin and Patrick Stefanini recommend “strengthen analytical monitoring» of the consumption of care, computerize the beneficiaries’ card, or increase the validity period of the title to two years instead of one, thus allowing controls “more in-depth“.

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 fight against “non-recourse” and the “breach of rights“. According to available data, some 50% of potential beneficiaries do not request the AME.

Among the measures envisaged: the organization of a health check upon arrival in the territory or the extension to beneficiaries of the obligation to declare a treating doctor.

Patrick Stefanini and Claude Évin differ on a few proposals: check, before heavy and expensive care, that this care is not accessible in the country of origin, or create the obligation for the holder of the AME to carry out a new application for a residence permit so that their AME can be renewed.

Created more than 20 years ago, the AME provides full coverage of medical and hospital costs granted to foreigners in an irregular situation present in France for at least three months.