The Little-Known Loophole Migrants Exploit for Free Medical Treatment and Residency

French publication Marianne has released an exclusive investigation revealing widespread exploitation of the “residence permit for care,” initially created for exceptional medical cases but now widely used by non-resident foreigners seeking expensive, free treatments in France.

According to the report by Ève Szeftel, Marianne’s editorial director, this practice significantly burdens France’s already overstretched public hospitals.

Initially introduced by Interior Minister Jean-Pierre Chevènement in 1998, the permit aimed to assist critically ill patients, including those originating from France’s former African colonies with AIDS, whose deportation would equate to a death sentence.

Foreigners are effectively permitted to obtain or renew a residence permit for the duration of their medical care. Anyone living in France for up to a year beforehand, who can prove they are unable to get the necessary treatment in their home country and who have not been convicted of any serious offenses, can apply for residency using this method.

However, the original intent has been considerably diluted. The report suggests that permits are frequently granted today without proper adherence to the original criteria. Many recipients, including those from countries like Algeria, Kosovo, Georgia, Bangladesh, and even the United States, reportedly come to France solely to receive costly medical treatments unavailable or unaffordable in their home countries.

Between 2017 and 2024, 228,000 applications were submitted, with 58 percent being granted. As a result, State Medical Aid (AME) expenditure has soared from €139 million in 2000 to €1.2 billion a year, with more than 440,000 ongoing beneficiaries.

The influx has generated substantial financial strain, raising concerns over the sustainability of France’s social security system, currently experiencing a deficit of €15.3 billion. The situation has also caused tension within healthcare facilities, with medical staff reporting pressure or being threatened to issue false diagnoses to make it easier for illegal migrants to obtain legal permission to stay on medical or compassionate grounds.

Dr. Thanh Le-Luong, former chief medical officer of the French Office for Immigration and Integration (OFII), confirmed the exploitation of the system, noting that smugglers actively promote specific medical destinations within France based on treatment types.

Political implications are becoming increasingly clear, as healthcare professionals reportedly shift their political support due to frustrations over unchecked abuses and worsening working conditions. Between the 2017 and 2024 presidential elections, support for Marine Le Pen among hospital civil servants reportedly doubled, rising from 17 percent to 34 percent.

In December last year, lawmakers from the center-right Les Républicains (LR) tabled a bill to abolish the residence permit for care.

The bill states, “Originally, it was mainly a question of allowing foreigners in an irregular situation, who had been present on our soil for some time, to be regularized to receive treatment against the human immunodeficiency virus (HIV), which did not exist in their country of origin. However, it now overwhelmingly concerns foreigners who have come specifically to France to benefit from the treatment of chronic diseases linked to lifestyles (obesity, diabetes, cardiovascular diseases, cancers).”

It further highlighted that the migrants can still claim residency using this method if the treatment is simply more expensive in their country of origin.

In its most recent annual report, the OFII stated, “It is not always a question of looking for care that is not available in the country of origin, but that of care of better quality than that which exists there, or of very expensive and innovative care, which only a system such as the Health Insurance in France can offer.”

Head of the LR parliamentary party, Laurent Wauquiez, told Le Parisien earlier this year that the scheme “is not talked about much and is very expensive,” costing the state “hundreds of millions of euros” every year.

In the latest data available for residence for care permits, some 2,103 Algerian nationals were granted residency this way in 2022 — 7 percent of all Algerians to be granted permits that year.

Algerians were the largest recipients of these residency permits that year, followed by migrants from Côte d’Ivoire (1,700) and Georgia (1,500).

Head of the National Rally, Jordan Bardella, has also vowed to abolish the scheme should his right-wing party enter the government, calling for “an end to the scandal of visas for care, that is to say, visa holders to be treated in our country at the taxpayers’ expense.”