The right has promised not to vote on the immigration bill if the regularization of undocumented workers in “strained occupations” is maintained. But this also requires a reform of state medical aid, which divides the executive.
Repeatedly postponed, criticized on the left and right and contested by associations defending exiles… The immigration bill arrives in the Senate, Monday, November 6, with incendiary debates in perspective.
The main point of friction concerns article 3 of the text, which provides for the regularization of undocumented workers in “jobs in shortage”. The right made one ” Red line “, while the majority is divided on the need to keep it. But discussions also promise to be heated on the transformation of state medical aid (AME) into “emergency medical aid”.
The government bill did not initially provide for a reform of this aid, which offers coverage of health costs to illegal foreigners present in France for at least three months and with very low income. But the text, amended by the Senate Law Committee, controlled by the right, now plans to limit the AME healthcare basket to “treatment of serious illnesses and acute pain”has “regulatory vaccinations” and to “pregnancy-related care”.
The right sees it as a “breathtaking” step forward for immigration
Historical target of the right and the far right since its creation in 2000, the AME is regularly accused by its detractors of being expensive “too expensive” – approximately 1.2 billion euros annually for 400,000 beneficiaries, or 0.5% of Health Insurance expenditure. “ I noticed that over the last ten years, (…) the cost has doubled, which well exceeds a billion.”reports the president of the LR group in the Senate, Bruno Retailleau, to Public Senate.
The right and the extreme right also accuse the AME of generating a “air call” for illegal immigration. Moreover, “ the AME gives access to a basket of care which is almost that of the residents” French, deplores the president of the LR group in the Senate, Bruno Retailleau, to Public Senate.
A report (PDF document) of the General Inspectorate of Finances and the General Inspectorate of Social Affairs recalled in 2019 that offering a minimum level of support to foreigners in an irregular situation was obligatory, in particular because of France’s international commitments. But this report also underlined that the AME was ” one of the (systems) the most generous in the European Union.
However, the report advised “to cautiously consider any changes to the AME (…), in particular a further reduction in the basket of care”. He considered that this last solution presented “significant health risks public. And also that she could be “counterproductive from the point of view of the efficiency of public spending”A “a delay in care leading to a worsening of the state of health”or, finally, “to more expensive care”.
A divided government
On the government side, it’s the big gap. Searching for months for a compromise with the right, the Minister of the Interior, Gérald Darmanin, declared in The Parisian favorable ” personally “ to the idea of restricting the AMEattracting the wrath of part of the executive.
Olivier Véran, the government spokesperson and doctor, for his part assumed “a real disagreement” with the Minister of the Interior, defending the current system. Hearing in the Senate, the Minister of Health, Aurélien Rousseau, also defended a “public health system”the deletion of which could result in “the dumping on the hospital of all urgent care” and the ” diffusion “ infectious diseases such as tuberculosis. A position shared by the medical profession: at the beginning of November, more than 3,000 caregivers, including the Nobel Prize winner in medicine Françoise Barré-Sinoussi, mobilized via a platform in The world to defend the AME.
A pre-report to decide
To decide the position of the executive, the Prime Minister, Elisabeth Borne, entrusted a mission to examine the system to two political veterans with opposing profiles: Patrick Stéfanini, from the right and specialist in immigration issues, and Claude Evin, former Minister of Social Affairs of the PS. “The government’s position will of course depend on the conclusions”she assured, asking ” everyone “ of “pull in the same direction”.
If the final report is expected on December 2, a pre-report was submitted Thursday, November 2 to Matignon. “The AME is not a factor of attractiveness”, believe the two signatories, report The echoes. They also strongly oppose the distinction between urgent and non-urgent care, which doctors themselves sometimes have difficulty making. The authors of the pre-report, on the other hand, propose adaptations to the AME, such as its time limitation, believing that aid that is too long can encourage people to remain underground.
Beyond the substantive arguments, part of the majority could want to give in to LR to ensure its vote, thus avoiding a new adoption of a text without a vote via recourse to article 49.3.
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