The system “can inevitably be improved. There are proposals (…) that we will study very quickly”, declared the Minister of Health Aurélien Rousseau, following the submission of the report by former PS Minister Claude Evin and the prefect Patrick Stefanini, figure of LR.
“But this has no place in the immigration bill: it is not an immigration subject, but a public health subject,” he added Monday during a visit to the Remiremont hospital (Vosges).
The AME is regularly targeted by the right and the far right, who accuse it of generating a “draft” for illegal immigration and of costing “too expensive” – 968 million euros in 2022. for 411,364 beneficiaries.
As part of the “immigration” bill, currently being examined by Parliament, the Senate removed the AME to replace it with more restrictive Emergency Medical Assistance.
But for MM Evin and Stefanini, the AME “is a useful health system”, “generally controlled” and “which does not generate consumption of care revealing atypicalities, abuses 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 person “remained 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 AME would lead to “a general increase in complexity”, particularly in assessing what constitutes urgent care and what does not.
The social SAMU of Paris on December 24, 2002AFP/Archives / FRANCOIS GUILLOT.
The two rapporteurs nevertheless list a series of possible “adaptations”.
They propose in particular to “withdraw the right to AME” from “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, specifies the report.
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 “beneficiary status” might be reserved “only for minor children”, the other members then having to submit their own request, they believe, also suggesting taking into account “the resources of the entire household” to admission.
Divergences
MM. Evin and Stefanini recommend “strengthening analytical monitoring” of healthcare consumption, computerizing the beneficiaries’ card, or extending the validity period of the title to two years instead of one, thus allowing “more in-depth” checks.
They also propose expanding the list of benefits which would no longer be delivered automatically but only following an agreement with Health Insurance.
And suggest some adaptations to combat “non-recourse”. According to available data, some 50% of potential beneficiaries do not request the AME.
Claude Evin in Paris on September 23, 2013AFP/Archives / KENZO TRIBOUILLARD.
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 Evin 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.
In the National Assembly, which will examine the immigration bill next week, LR MP Véronique Louwagie, supporter of the AMU, regretted “the incomplete nature of certain avenues of proposals” from the rapporteurs.
“This subject must be addressed. Whether in an immigration text or in another,” she said.
