This article reconstructs the socio-historical processes that have led to the formal inclusion and marginalization of “irregular migrants” in the French public health insurance system and the parallel legal production of exclusion of a share of this group. It interrogates the binary inclusion/exclusion in the field of healthcare linking it to the logic of sovereignty and governmentality in a stratified society. It shows how these processes have led to unequal health practices and increased obstacles to accessing health insurance and healthcare providers, and, consequently, has resulted in the exclusion of a share of this group from the regular healthcare system. These two levels of discrimination are illustrated using empirical research on departments in French public hospitals that have been designed to enable access to care for individuals without insurance (Permanence d'accès aux soins de santé, or PASS: health care access units). © 2017 The Author. International Migration © 2017 IOM

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international migration health care reform process France sovereignty