France to end health ban

Announcements from the European Commission and the French government reveal an about-turn on France’s 2007 decision to force so-called “inactive” non-French EU citizens to take out private health insurance.

The 2007 ban caused uproar among expats at the time and made it impossible for many people with long-term illnesses to settle in France. Early retirees will now get access to the CMU [France’s reimbursement system for those who have not accrued rights through work in France] with full details to be given in a government circular in the next few weeks.

The reversal follows pressure from the EU, whose rules on coordination of countries’ social security systems require equal treatment of European citizens. A commission spokeswoman said: “France will publish a circular before the summer break that opens access to the CMU.” She added: “The equal treatment regulations apply as soon as a person is seen as habitually resident in a country, which is a question of fact as to where their centre of interests lies.” EU citizens living in France and not covered by European E121 or E106 forms (now both called S1) will be treated like French nationals in terms of CMU access, she said.

This would apply equally to people moving to France. S1s entitle you to have healthcare paid for by the state you left and are temporary [the former E106] for those who have paid recent National Insurance or permanent [the former E121] for state pensioners or people on incapacity benefit.

A spokeswoman for France’s Direction de la Sécurité Sociale said a new ministerial circular would be published, replacing the one from November 23, 2007. “It clarifies the different ways in which an inactive EU citizen can legally live in France through French state health insurance, bearing in mind new regulations on coordination or national legislation, or a private policy with a range of care comparable to the state’s,” she added. “A case-by-case examination of necessary, allow access to the CMU.” CMU (couverture maladie universelle) recipients pay 8% of their income or have free access if on very low incomes.

All early-retirees formerly joined it if necessary but, following a change of government policy, in late summer 2007 some local state health insurance bodies (Cpams) started sending out letters telling “inactive” expats that they would have to leave in 2008 and use private insurance.

There was confusion as full private health cover replacing state cover had not previously applied in France but there was also much distress, especially for those with life-threatening or terminal illnesses. The Connexion was the first newspaper to break the story and was among those campaigning for a change in the policy and talks took place between the health ministry and the British Embassy and between the British and French Europe ministers.

MEP Mary Honeyball was among British politicians who took up the fight. Ultimately a compromise was reached, allowing those in the CMU before November 23 2007, to stay, and it was subsequently agreed those on E106s before that date would be allowed to join. Others could only join if able to prove five years’ residence or an unforeseeable “life accident” since coming to France which had left them unable to afford or obtain private insurance. This included developing a chronic condition or divorcing.

Having a private policy with “comparable” cover to the French state’s became a legal requirement for residence. There was no guidance however as to which policies qualified and, according to some health experts, arguably none that replaced the state’s. The European Commission has been in talks with France since last year after it was found these policies were likely to break EU law. It initiated “infringement” proceedings but says it will close these once the new circular is published. It will also monitor its working.

Campaigner Deborah Dudley, of the French Health Issues pressure group, said: “This is great and it is what we’ve been saying should be done all along. I have friends who’ve had a really tough time and had to sell up and move back to the UK because their E106s were running out and they couldn’t stay. “As for the ‘life accident’ rule some people have had a terrible time with some Cpams and not been able to use it successfully. It’s taken a long time and a lot of effort to get back to where we were before.”

Mrs Dudley said people in the process of moving when the rules changed in 2007 were hardest hit. “Some people had just moved to France and had E106s but had not yet registered them with a Cpam, so had to return. “Others were making plans to move but had to give up. “People are now saying ‘finally we can move’, because they had been stuck. It was the issue of needing full cover, and if you have any health problems [which insurers will want to exclude] that’s not an option.”