It’s official: U.S. and other non-EU/EFTA nationals will contribute to the costs of healthcare in France from 2026 onward.

There had been considerable press coverage of an amendment to the French Social Security budget by Horizon Party member Deputy François Gernigon, who rallied support for the measure by drawing attention to American retirees who benefit from the French healthcare system without paying either income tax or social charges in France. I referred to the status of this amendment in two Notes issued on 12 and 14 November 2025.

As of today, 1 January 2026, the text of the amendment has been adopted as Article 53 of LOI n° 2025-1403 du 30 décembre 2025 de financement de la sécurité sociale pour 2026, and has been published in the legifrance.gouv.fr/jorf…. The text is reproduced below:

« Art. L. 160-1-1. - Sous réserve des conventions internationales et des règlements européens, toute personne qui réside en France de manière stable et régulière, qui n'y exerce pas d'activité professionnelle et qui n'est pas redevable des cotisations et contributions mentionnées aux articles L. 131-9 et L. 136-1 en vertu d'une convention internationale bénéficie de la prise en charge des frais de santé mentionnée au premier alinéa de l'article L. 160-1 à la condition de s'acquitter d'une participation financière. « Lorsque la personne ne s'acquitte pas de cette participation financière pendant une durée déterminée, le directeur de l'organisme chargé de la prise en charge des frais de santé lui notifie, après vérification de sa situation, que le bénéfice de son droit à la prise en charge des frais de santé sera suspendu si elle ne s'acquitte pas du montant dû. « Un décret en Conseil d'Etat détermine les modalités d'application du présent article, notamment celles relatives au montant, à la notification et au recouvrement de cette participation ainsi qu'à la suspension du droit à la prise en charge des frais de santé lorsque la personne ne s'en acquitte pas. »

English translation:

“Art. L. 160-1-1. - Subject to international agreements and European regulations, any person who resides in France on a stable and regular basis, who does not exercise any professional activity there and who is not liable for the contributions and payments referred to in Articles L. 131-9 and L. 136-1 pursuant to an international agreement, shall be entitled to the healthcare coverage referred to in the first paragraph of Article L. 160-1, provided that they pay a financial contribution.

“Where the person fails to pay this financial contribution for a specified period, the director of the body responsible for covering healthcare costs shall, after verifying their situation, notify them that their entitlement to healthcare coverage will be suspended if they do not pay the amount due.

‘A decree of the Council of State shall determine the terms and conditions for the application of this article, in particular those relating to the amount, notification and recovery of this contribution, as well as the suspension of the right to healthcare coverage when the person fails to pay it.’

As written, the law applies to individuals who are legally and ordinarily resident in France and who are not employed, who do not pay pertinent social charges, and who are not covered by an existing bilateral agreement with their home country. Whereas the first two of these conditions would be self-evident, the third will undoubtedly be clarified as part of the decree which the law mandates. Nevertheless it will undoubtedly apply to citizens of the United States and some other non-EU/EFTA states who reside in France on a visa de long séjour, valant titre de séjour (VLS-TS).

As for the amount that will be charged and how it will be administered, there will be speculation until the decree is issued. Also expect questions to be raised about its relationship to the so-called taxe Puma (legalstart.fr/fiches-pr…, its relationship to existing bilateral tax treaties (again raising the question of whether the social contribution comprises a tax), etc., until such time as a decree is issued.

Moreover, expect a non-trivial implementation phase following issuance of a decree, including establishment of administrative guidance and procedures to be followed by CPAM and l’Urssaf. So, while the law is in effect from 1 January 2026, it is unlikely to be fully implemented for some months or even before 2027.