Expathealthdirect’s Peter Owen sheds a measured light on a largely exaggerated situation following Mike Meade's outline on the background to the recent panic.

There is an update to this article here and other relevant links are here. 
The "Sécu" also offers guidance on this and other related topics in English here. 

Inspired by distortions by an “expert”, several British newspaper reports in early September sent an unjustified wave of panic through the expat community in France. The stories, and their enhanced internet repeats, conjured up visions of masses of British expats being “brutally” abandoned by the Securité Sociale under direct instructions from President Sarkozy.

Early on during his election campaign, the candidate Sarkozy made his feelings clear: “If you think 53 makes you old enough to retire, then fine, go ahead and retire. But don’t expect the state to pay for it.” The new measure simply puts this theory into practice.

Until now some Britons who were previously covered by the NHS and who took up French residence before retirement age benefited from France’s healthcare system without having ever paid into it. It was a profoundly unfair situation especially since many of these expats had never paid into the NHS either. They simply benefited from NHS cover by virtue of their previous UK resident status. Some did indeed pay into the clapped out old banger of an NHS but then received the sleek racing car of the Securité Sociale when they took early retirement in France.

Sarko seems to want to weed out a few freeloaders and the many comments on the London Times website largely support the French attitude. One British comment — “Sarkozy's dead right and we should follow suit” - echoed most opinions.

So what’s the reality? As an expat, your right to the same healthcare as the locals is unaffected if any of these situations apply to you:

• you work (or worked until retirement age) legally in France either as self-employed or salaried
• you pay your annual 8% contribution into the French CMU system
• you were covered by the NHS in Britain and you are above retirement age and in receipt of the UK state pension
• you are a visitor covered by the EHIC card for necessary care 

Here Peter Owen sets the record straight on who might be at risk:

The legislation refers to immigration and integration of foreigners in France and conditions of residence. One of these conditions is having adequate financial resources and not being a burden on the social security system including health.

 Those affiliating to the CPAM via E Forms (E121, E106 etc) are not affected at all by this legislation.

Expathealthdirect has no evidence that those who are affiliated under the CMU legislation (ie; under residence criteria and are paying the 8% "cotisation") are affected either.

More vulnerable are those who do not pay contributions and have a free "top up" insurance (because of low declared income) and are therefore receiving almost free healthcare. It implies that you may not have the financial resources to live in France — which has always been a condition of residence. With the demise of the "carte de séjour" for EU/Swiss nationals it has been a difficult rule to enforce but even those in this category have been acting in accordance with CMU Law 99-641 dated 27 July 1999.

The most vulnerable of all, and deservedly so, are those who have managed to affiliate via residence criteria and have under-declared their income or have not made a French tax return at all. The new measure targets mainly these people and their resident families.

For those UK nationals below retirement age who come to live but not work in France an E106 can be obtained which is valid for up to 2 years. To date if they were still under retirement age on expiry of their E106 they simply transferred to the CMU scheme and paid the 8%. What is not clear at this time is if such people will continue to be able to make this transfer or whether the CPAM will simply withdraw cover at this point.
Refusal of the CPAM to cover after E106 expiry is not at all certain but not to be ruled out either and it is a topic we will explore — perhaps for a later issue when the new measures are put into actual practice. It looks quite probable (but not sure) that those who show declared income above the thresholds and therefore are subject to the 8% cotisation will be accepted as before whereas those not filing French income tax returns will be refused.

This is a constantly evolving subject and the picture will be clearer as CPAM offices interpret this new legislation. The initial assessment, therefore, is that any threat of large scale withdrawal of health cover for those in the expatriate community is unjustified.

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