Asylum seekers are entitled to access health care on equal grounds as French nationals in regards to coverage and conditions. This also applies to unaccompanied children as long as they have the support of the social services. Undocumented migrants can access health care free of charge (with minor exceptions) through a parallel administrative system called "Aide Médicale État" (state medical assistance). However, to obtain the AME and enjoy these entitlements, they must comply with two conditions: residence in France for more than three months and be under a certain economic threshold. To comply with these conditions, they have to follow a number of administrative steps and sometimes even provide supplementary evidence. This all represents a significant obstacle to accessing health care effectively.
All other undocumented migrants can access emergency care, ante and post natal care, abortions and medical terminations of pregnancy as well as treatment of HIV, and other infectious diseases - such as tuberculosis free of charge.
A proposal for a new law (that could come into force in 2011) requests adult undocumented migrants to pay an annual contribution of 30 € to benefit from the AME. This would mean the end of free access to health care for undocumented migrants in France.
Download the report on the French legislation on the access to health care for undocumented migrants and asylum seekers (in French).
Download the Comparative overview of the legislation on access to health care for undocumented migrants and asylum seekers in 16 countries. Download the French version.
Since months now, there is an attempt to break residence permit for medical reasons, which entitles undocumented migrants who habitually reside in France and who need healthcare to stay in France as long as they cannot effectively access to appropriate treatment in their country of origin. The Senate lately voted an law amendment on this issue, which they presented as a compromise text between the existing law and the amendment voted by the National Assembly (Parliament) in March. But in reality, this text is much more restrictive: according to it, seriously-ill undocumented foreigners could be protected from expulsion only if the treatment they need does not exist in their country of origin. The text also excludes the doctors from the decision process, and leaves the State representative (préfêt) free to interpret the medical situation as he choses. The last chance to have this text rejected is that the Commission that has now to review it goes back on this decision.
Since the late '90s, undocumented migrants who habitually reside in France and who need health care to the extent that the lack of treatment could bring exceptionally serious consequences to health status have the right to stay as long as they cannot effectively benefit from appropriate treatment in their country of origin.
The draft French immigration bill has been under discussion at the Senate since the beginning of February, following its reading by France's National Assembly last autumn.
While the national assembly had voted many restrictions to 'State medical aid' ('Aide médicale d'État' or AME) in November, the French senate had voted against those same restrictions in early December. Therefore, the 'Joint commission', composed half of national assembly and half of senate members, had to make the final decision. On 13 December, it decided to adopt the various restrictions to 'State medical aid'.
Source : ODSE, Réforme en cours de l'Aide médicale d'État
As part of the law on the budget for 2011, the conditions to access to the AME (state medical insurance for undocumented migrants) were discussed by the French Parliament. Following propositions of the right party, the proposal requesting adult undocumented migrants to pay an annual contribution of 30 € to benefit from the AME and requesting an authorisation from the French heath administration office (CPAM) to validate that a beneficiary of the AME will receive hospital care was voted by the members of Parliament. It will be voted by the Senate within a few weeks and if voted, would come into force in 2011, putting an end of free access to health care for undocumented migrants in France. Collective action is being taken by Médecins du Monde and other key organisations in France against this measure on grounds that it is dangerous in terms of public health, economically unsound as well as socially unjust and discriminatory.
Sources :
- Médecins du Monde, « Démantèlement de l'Aide médicale d'Etat : La Ministre de la santé renonce à défendre la santé des plus pauvres »
- GISTI, « Attaques contre l'Aide Médicale d'État : opposition des associations »
Debates on the proposal for a new French immigration bill started on 28 September at the "Assemblée Nationale". The proposal has been strongly criticised by the diverse organizations working on migration issues. These argue that the bill is likely to violate the fundamental rights of migrants and refugees, and that the proposal reduces the power of the judges in favor of administrative authorities. Thomas Hammarberg, Council of Europe's Human Rights Commissioner, has also showed his concern.
Since 1998, the French law provides for a renewable one-year residence permit for foreigners residing de facto in France whose medical condition requires treatment or care the lack of which can have exceptionally serious consequences, provided that they cannot benefit from an appropriate treatment in their country of origin.
The Council of State, the highest administrative court in France, recently stated that effective access to health care is not only about the simple existence of appropriate medical care in the country of origin but also depends on the current and future availability of the care or treatment needed, the financial and geographical accessibility, discriminations when accessing the care or treatment needed and, more generally, all exceptional circumstances specific to the individual case.
A report from French Senator Isabelle Debré (UMP) to the Prime Minister highlights the urgency and necessity of more action towards foreign unaccompanied minors in France. The report calls for a more coherent response in the areas of protection, social services and regularisation of unaccompanied minors. Welcoming the report and recalling the EU Commission's action plan on unaccompanied minors recently published, NGO FTDA calls for more action from the French government, but also for a European response to the issue.
Sources:
- France Terre d'Asile, 'Call for a European protection of unaccompanied children'
- ECRE Weekly Bulletin, 4 June 2010.
The High authority to fight discrimination and promote equality (HALDE) denounces discriminations and important breaches to the right to health in Mayotte. It concludes that claims of discriminations of undocumented migrants and their children, or of unaccompanied children, when accessing health care, are well-founded. It asks the authorities to put 'State medical aid' or an equivalent medical coverage in place in Mayotte and also, considering the obvious violation of provisions of the United Nations Convention on the Rights of the Children (UNCRC), that children of undocumented migrants and unaccompanied children can be directly affiliated to social security.
Source: migrants outre-mer