Will you need a French ID card to use the carte vitale?
French prime minister Gabriel Attal is pushing ahead with a plan to combat benefit fraud and medical tourism, but there is one aspect that could also affect foreigners who live in France - a requirement for a French ID card in order to use the carte vitale health card.
The plan to combat benefit fraud was first unveiled in 2023, but the prime minister has reportedly flagged it as a 'priority' to bring into effect in 2024.
In among plans to restrict access to social benefits such as unemployment benefits and family payments to people who spend a significant part of the year outside France was a proposal about the carte vitale health card.
Attal said: "I want to move gradually towards merging the carte vitale card and the identity card into a single secure card, as is the case in Belgium, Portugal and Sweden. This is both a simplification measure and an additional guarantee of the individual's identity and associated rights."
He added: "The issue now is cartes vitale used for illegal medical tourism. People coming to France and using someone else's carte vitale for treatment."
Over the last five years, 2.3 million cartes vitale have been deactivated because they were "surplus", according to Attal.
So why is this a problem for foreigners living in France?
The carte vitale is the card that proves that you are registered in the French health system - when accessing treatment, you present your card and a certain percent of the cost of your appointment or prescription is reimbursed by the French state.
READ ALSO How the carte vitale works and how to get one
Anyone who has been living full time in France for more than three months is entitled to a carte vitale - there is no need to be a French citizen - and the vast majority of foreigners living in France have the card, and use it to access healthcare.
The French ID card, on the other hand, is only available to French citizens - including foreigners who have been naturalised as French. It is carried by virtually all French people (although it is not compulsory) and acts as a combined proof of ID, proof of French citizenship and travel document (if you are travelling within the EU).
There are, therefore, many thousands of people who are legally resident in France and who have a carte vitale, but do not have a French ID card.
It is possible to access healthcare in France without a carte vitale - but it means that the state will not reimburse the cost. Patients must therefore pay out of pocket or rely on private health insurance, which is unaffordable for many.
READ ALSO How France's public healthcare system works
So what will happen to foreigners with no French ID?
The plan is still in the very early stages at the moment - any change to this system would have to be drafted into a bill, presented to parliament and passed into law. It would also have to go through several checks from regulatory bodies - including a review by France's data protection authority, CNIL, in order to determine whether it will be legal to combine identity data with health data, as well as how to make such a combination card secure.
People who are legally living and working in France are entitled to register in the healthcare system, while the Brexit Withdrawal Agreement also guaranteed healthcare for Brits who were living in France before 2021.
In short, French authorities would have would have to introduce some kind of different system for foreign carte vitale holders, otherwise it would, in effect, amount to stripping them of their rights.
French daily Le Parisien noted that "there are still several questions outstanding" around this plan, particularly for the many foreign residents who benefit from a carte vitale, but do not hold a French ID card as well as for those French nationals who also do not have the ID card, because it is not technically mandatory.
The French data protection watchdog CNIL has stated in response to the idea that the government "must ensure that alternatives to the use of identity cards are maintained".
Waiting times
On top of the legal and political hurdles is a practical one - waiting times for a new carte vitale are already very long, and reissuing the cards to all of France's roughly 67 million residents would be an enormous task.
A proposal to create a biometric carte vitale - under the same conditions as the current card but with added security measures such fingerprints - was made last year, at an estimated cost of €250 million.
It ran into opposition both on cost and practicality grounds, with many doctors also opposed to it as risking excluding the elderly and other vulnerable groups from healthcare and was later quietly scrapped.
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The plan to combat benefit fraud was first unveiled in 2023, but the prime minister has reportedly flagged it as a 'priority' to bring into effect in 2024.
In among plans to restrict access to social benefits such as unemployment benefits and family payments to people who spend a significant part of the year outside France was a proposal about the carte vitale health card.
Attal said: "I want to move gradually towards merging the carte vitale card and the identity card into a single secure card, as is the case in Belgium, Portugal and Sweden. This is both a simplification measure and an additional guarantee of the individual's identity and associated rights."
He added: "The issue now is cartes vitale used for illegal medical tourism. People coming to France and using someone else's carte vitale for treatment."
Over the last five years, 2.3 million cartes vitale have been deactivated because they were "surplus", according to Attal.
So why is this a problem for foreigners living in France?
The carte vitale is the card that proves that you are registered in the French health system - when accessing treatment, you present your card and a certain percent of the cost of your appointment or prescription is reimbursed by the French state.
READ ALSO How the carte vitale works and how to get one
Anyone who has been living full time in France for more than three months is entitled to a carte vitale - there is no need to be a French citizen - and the vast majority of foreigners living in France have the card, and use it to access healthcare.
The French ID card, on the other hand, is only available to French citizens - including foreigners who have been naturalised as French. It is carried by virtually all French people (although it is not compulsory) and acts as a combined proof of ID, proof of French citizenship and travel document (if you are travelling within the EU).
There are, therefore, many thousands of people who are legally resident in France and who have a carte vitale, but do not have a French ID card.
It is possible to access healthcare in France without a carte vitale - but it means that the state will not reimburse the cost. Patients must therefore pay out of pocket or rely on private health insurance, which is unaffordable for many.
READ ALSO How France's public healthcare system works
So what will happen to foreigners with no French ID?
The plan is still in the very early stages at the moment - any change to this system would have to be drafted into a bill, presented to parliament and passed into law. It would also have to go through several checks from regulatory bodies - including a review by France's data protection authority, CNIL, in order to determine whether it will be legal to combine identity data with health data, as well as how to make such a combination card secure.
People who are legally living and working in France are entitled to register in the healthcare system, while the Brexit Withdrawal Agreement also guaranteed healthcare for Brits who were living in France before 2021.
In short, French authorities would have would have to introduce some kind of different system for foreign carte vitale holders, otherwise it would, in effect, amount to stripping them of their rights.
French daily Le Parisien noted that "there are still several questions outstanding" around this plan, particularly for the many foreign residents who benefit from a carte vitale, but do not hold a French ID card as well as for those French nationals who also do not have the ID card, because it is not technically mandatory.
The French data protection watchdog CNIL has stated in response to the idea that the government "must ensure that alternatives to the use of identity cards are maintained".
Waiting times
On top of the legal and political hurdles is a practical one - waiting times for a new carte vitale are already very long, and reissuing the cards to all of France's roughly 67 million residents would be an enormous task.
A proposal to create a biometric carte vitale - under the same conditions as the current card but with added security measures such fingerprints - was made last year, at an estimated cost of €250 million.
It ran into opposition both on cost and practicality grounds, with many doctors also opposed to it as risking excluding the elderly and other vulnerable groups from healthcare and was later quietly scrapped.
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