Does state health aid (AME) have an “attractive effect”? Should we change the care covered by this health insurance plan, which benefited nearly 440,000 undocumented aliens by mid-2023? Does reform pose risks to public health or hospital finances?

These are the questions that the evaluation mission entrusted by the government to the former socialist health minister Claude Evin and the former prefect and right-wing man Patrick Stefanini had to answer. The work was published on Monday, December 4, when the Senate voted on an amendment to delete the AME in November during consideration of the “immigration” bill. The right and center wanted to combat the costs associated with this system, which amount to around 1 billion euros.

A few days before the text reaches the National Assembly in public session on December 11, the Evin Stefanini report offers the government a way out as it is divided on the need to address the AME. On the one hand, when passing his law, Interior Minister Gérald Darmanin wants to find common ground with the right, in whose eyes the AME is the symbol of laissez-faire migration; On the other hand, Prime Minister Elisabeth Borne, government spokesman Olivier Véran and Health Minister Aurélien Rousseau showed their solidarity with the AME, reflecting the overwhelming majority opinion in the medical world.

Despite some paradoxes, the proposals formulated by the rapporteurs move between these two lines. She “may be subject to regulatory or legislative changes”, explained Mr. Darmanin and Mr. Rousseau on Monday in a joint press release, believing, on the other hand, that they could not be integrated into the “immigration law” at the risk of being rejected by the Constitutional Council because they would be considered as “legislative riders “, i.e. those that have no connection to the text. The Legal Affairs Committee of the National Assembly has already removed the senatorial amendment that buried the AME.

“Confirmed health benefits”

Mr Stefanini and Mr Evin are called upon to shed light on the debates and reiterate this “The health benefits [de l’AME] it is confirmed “. They believe that the Senate’s project to replace the AME with emergency medical assistance includes: “Significant risk of foregoing care” WHO “would have the triple impact of worsening the health of those affected, possible public health consequences and increased pressure on health facilities”. Without AME, foreigners would no longer be able to use community medicine, hospitals would be under greater strain, conditions would deteriorate and therefore be more expensive for the healthcare system.

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