• An LR senator welcomed the vote of an amendment in the Senate abolishing State Medical Aid. "We must stop the distribution of uncontrolled aid, which creates a migratory 'pull of air', which the France no longer controls at all," she wrote.
  • In 2019, the Defender of Rights called this argument "a misconception".
  • According to a survey conducted by researchers, 10% of respondents eligible for this aid cited health as the reason for coming to France. However, less than one in two eligible men (47%) and 60% of women benefit, according to the same survey.

The Defender of Rights or even researchers repeat it: the State Medical Aid (AME) does not create a "migratory air appeal". Yet this is what Senator Françoise Dumont advanced Wednesday in a tweet. Senator Les Républicains welcomed the vote on an amendment that replaces this aid with "emergency medical assistance", which offers less comprehensive health care coverage and is accessible after the payment of stamp duty.

3/3-! !️ We must stop the distribution of uncontrolled aid, which creates a migratory "pull of air", which the France no longer controls at all.

— Françoise Dumont (@FrDumont83) March 15, 2023

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This amendment was adopted while senators were debating in committee the immigration bill defended by Gérald Darmanin, the Minister of the Interior, and Olivier Dussopt, the Minister of Labour.


  • What is state medical aid?

This scheme is intended for foreigners who have been illegally present in France for at least three months and who do not exceed a ceiling of resources (9,571 euros per year for a single person, 14,537 euros for a couple). Proof of identity and residence is required to qualify for entitlement.

This aid opens the right to 100% coverage of certain care, within the limits of Social Security rates, says the site of the Health Insurance. Finally, some care considered non-urgent "is covered after a period of nine months after admission to the AME", adds the Health Insurance.

The main reasons for care are childbirth, tuberculosis and HIV, according to a 2015 parliamentary information report cited by the Defender of Rights.

  • Does it really create a migratory "pull of air"?

In October 2019, Jacques Toubon, the Defender of Rights, regretted "the misconception that the 'generosity' of a device such as the AME would lead to strengthening illegal migratory flows by creating a 'call for air' while several studies show that the need for care is a completely marginal cause of immigration".

In November 2019, a survey conducted by researchers from the University of Bordeaux and IRDES (Institute for Research and Documentation in Health Economics) among foreigners eligible for the AME, reinforces this observation: 10% of respondents cited health as the reason for coming to France. The main reasons for coming to France were economic or social respondents for 47%.

"The reason for health may correspond to the fact of declaring to have come to France 'to treat oneself', but more generally 'for health'", detail the researchers. This health motivation can be linked to other motivations, economic, social, private and political.

The researchers also observed that not all people eligible for this medical aid benefit from it. Thus, less than one in two men (47%) and 60% of women benefit from it. This access to this system is also correlated with the length of stay in France: the longer it is, the more people benefit from it. 24% of people who have been in the country for at least three months and less than a year are covered, compared to 65% for those who have been present for five years or more. The researchers point out, however, that "a significant proportion of people without a residence permit who have settled permanently in France remain uncovered".

Moreover, declaring that they had come to France for a health reason does not then translate into a systematic use of AME: 34% of those who cited this reason did not have AME at the time of the survey.

What deters eligible people from using it? Ignorance of the existence of this system, the complexity of the procedures or the impossibility of providing proof of residence or income are reasons that emerge from this investigation. The sociologist Céline Gabarro, author of another survey, compared in 2022 obtaining this aid to an "obstacle course", highlighting the complexity of the procedures: the counters receiving applications vary according to the departments, the opening hours also. Officers sometimes ask for supporting documents that are not mandatory.

The amendment voted Wednesday by senators restores the payment of a stamp duty to access care. In 2011, access to the AME was also made payable, with a stamp duty of 30 euros. The device was abolished the following year, accused of delaying access to care and ultimately leading to more expensive hospitalizations.

  • Does Wednesday's vote by senators put an end to state medical aid?

To be adopted, a bill must be voted by the Senate and the National Assembly. The text has just passed in committee in the Senate. It will be examined at first reading from March 28 in the hemicycle of the Senate, dominated by the right-wing opposition, the vote on the entire text is scheduled for April 4, according to AFP. It must then be voted on by MPs, who can make changes to it. About 316,000 people were beneficiaries of the AME as of December 31, 2017.

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