British Columbia’s three-month waiting period for provincial health benefits is hitting racialized immigrant and migrant women the hardest, forcing them to choose between basic health care or food and other necessities, according to a new study.
Without access to timely routine checkups and testing during the wait period, particularly for pregnant parents and newborn babies, health conditions can worsen and have lifelong consequences, researchers at the Centre for Gender and Sexual Health Equity at the University of British Columbia found.
With clear evidence of the harm done to mostly poor and racialized migrants by B.C.’s policy, a coalition of 19 migrant rights, poverty reduction, civil liberties and labour groups are calling on the province to repeal the policy permanently.
“We can talk for days about the health impacts of the policy,” said Omar Chu, an organizer with Sanctuary Health in the Lower Mainland. “And at the same time, it’s also an emotional impact of people who struggle for permanent residence, they’re not eligible for the universal public health care that so many Canadians consider a core value.”
When someone moves to B.C., whether from another province or from another country on any type of visa, they are not eligible for basic provincial health coverage for the remainder of the month they arrived, plus two additional calendar months.
B.C. is the only province that has such a wait period without exceptions for newborn babies and pregnancy-related and emergency health care, as is the case in Quebec and Ontario. Other provinces don’t have a wait period. New Brunswick abolished its waiting period in 2010.
As the pandemic struck in March 2020, B.C. removed its waiting period for three months in response to the pandemic and extended MSP coverage briefly to temporary foreign workers.
When the measures ended in July 2020, Health Minister Adrian Dix defended the waiting period.
“We have a 90-day rule which means people cannot just come here and on the first day get health care, and get that health care at the cost of everyone in B.C.,” he said. “It’s fundamental to the way that we run our public health-care system in B.C.”
The Tyee has reached out to the premier’s office and the Health Ministry for comment.
Chu said advocates have been seeking an end to the waiting period for decades and the pandemic has shown how urgently change is needed.
“With cases spiking again, there’s no reason we should be disincentivizing people from accessing the health-care system,” he said.
In an open letter sent to Premier John Horgan, Opposition Leader Shirley Bond and Dix, Sanctuary Health and 18 other organizations said the policy violated a number of human rights’ conventions.
“Immigrant women perceive and experience the policy as deeply xenophobic, making them feel unwelcome and perpetuating mistrust and barriers to accessing needed health care for women,” read the letter.
Racialized immigrant and migrant workers often have jobs in frontline services, food processing and manufacturing, where they are more likely to contract COVID-19.
The pandemic has also caused delays of months and years in processing visas, work and residence permits. Migrants’ eligibility for MSP lapses each time their status does.
If someone’s student visa expires before their work permit is granted due to pandemic delays, Chu said, that lapse means they have to wait three months all over again for coverage.
And many can’t afford or aren’t eligible for private insurance to fill the gap, as pregnancy and other common health issues are considered pre-existing conditions and not covered.
The wait period for health coverage also applies to newborn babies whose parents are not yet eligible for MSP.
Study co-author Shira Goldenberg, director of research education at the centre and an assistant professor in global health at Simon Fraser University, said the lack of care for women and children during the waiting period leads to more expensive and invasive care being required once they are insured.
“There are health-care needs that can’t wait, like pregnancy, and that puts families in an impossible situation,” Goldenberg said in an interview.
“Many women ended up with more significant issues due to care being delayed.”
While some agencies can help fill the health-care gaps, the need to find workarounds increases the sense of racism and xenophobia many of the 47 women interviewed for the study said they faced in the health-care system.
The result is that migrants feel less deserving of care and less likely to seek it when needed in the future, Goldenberg said.
Both Chu and Goldenberg hope the province acts urgently on this evidence as the Omicron-driven fifth wave surges in B.C.
“The waiting period policy doesn’t align with the values that I think most British Columbians think we hold in terms of being an inclusive and welcoming province, and then here we are having one of the most xenophobic health-care policies in Canada,” said Goldenberg.
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