We talk less about it than about the regularization of illegal immigrants in professions in tension, yet this is the other subject that angers. A totem, too, is AME – this acronym for “state medical aid”. The system allows foreigners in an irregular situation to benefit from access to care. Created in 2000, it now costs some 1.2 billion euros for just over 400,000 beneficiaries in 2023, according to a report from the National Assembly. While the left jumps as soon as we dare to question a possible reform, the right and the extreme right love to promise its disappearance during electoral campaigns. Gérald Darmanin knows this well, who has seen LR activists up close. An Odoxa survey, published Thursday November 2 by Le Figaro, even indicates that 69% of French people are in favor of abolishing the AME.
This is precisely why, in the heart of summer 2022, when the famous immigration bill is drafted, the Minister of the Interior adopts a very restrained position during the arbitration meetings in Matignon: useless according to him to put the SOUL in the discussion. “Gérald told us that he would be dragged to the right if this point was raised and that this would put him in an impossible situation,” says a participant in the interministerial meetings.
He was right. Twice just. In the Senate, last February, the right-wing majority adopted in the Law Committee an amendment transforming the AME into AMU, emergency medical aid, focused on the management of the most serious situations and subject to the payment of a stamp duty. Objective: savings of around 350 million euros.
All eyes are then turned towards the professions in tension, soon the examination of the text will be completely suspended, but the worm is in the fruit. When the discussions resume, Gérald Darmanin, who is still looking for a majority to adopt his text and wants to send signals to the right, declares himself, in an interview with Europe 1, at the beginning of October, in favor of the amendment carried by the LR group in the Senate. Some Macronists almost choke, the Minister of Democratic Renewal and government spokesperson, Olivier Véran, makes this a red line.
Rousseau’s idea, Philippe’s fears
In Matignon, Elisabeth Borne is not particularly looking for a subject that could blow up her government and its majority. It is therefore logical that she appeals to Clemenceau: “When we want to bury a decision, we create a commission.” Thus was born the idea of a mission on the AME. When the name of Patrick Stefanini is put forward, it is worth a message. The positions of this former prefect who led the presidential campaign of Valérie Pécresse are known, since he exposed them in a book, Immigration. These realities that are hidden from us (Robert Laffont). He recalls that we went from 75,000 beneficiaries in 2000 to nearly 320,000, twenty years later, that AME beneficiaries consume on average 1,741 euros of care per year, compared to 1,580 euros for a beneficiary of the general regime; he also cites a report from Igas and the General Inspectorate of Finance, which describes the system as “one of the most generous in Europe” and notes “atypical situations in the care consumed by beneficiaries”. He suggests that illegal immigrants “pay their cost for care not included in the care basket.”
Behind the scenes, the new Minister of Health, Aurélien Rousseau, then had an idea: to put forward the name of one of his predecessors, the socialist Claude Evin, to create a balanced tandem, which Elisabeth Borne officially announced on October 8 on BFMTV . Because Rousseau, in private, is not the last to warn his government colleagues against the harmful effects of hasty change. He has difficulty seeing the savings of the reform and the excesses of the present situation. He is just exploring one avenue: making certain vaccinations compulsory to prevent the development of diseases that illegal populations are more likely to carry.
Meanwhile, Gérald Darmanin continues to move forward. “I will endorse the Senate’s modifications,” he announced on October 18, during questions to the government, confirming that he validated the senatorial amendment. In the Assembly, the president of the Laws Committee, the Macronist Sacha Houlié, does not hear it that way. He even makes this question of the AME proof that there is no point in giving in on professions in tension (article 3), since other demands from the right, like this one precisely, seem to him extravagant.
There is one who follows this game of ping-pong closely: his name is Edouard Philippe. It was he who, at Matignon, had imposed, against the advice of certain members of the presidential majority, restrictions on access to the AME, and he would not want his work to be written off. The Minister of the Interior is aware of his friend’s reservations – even his sensitivity -, but he takes pains to convince him that he was not able to complete the reform at the time. . The Senate begins Monday, November 6, the examination in public session of the entire immigration bill. Parliamentarian will then really be a profession in tension.
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