The BC Federation of Labour has endorsed a petition launched by the Centre for Gender and Sexual Health Equity to end British Columbia’s mandatory three-month wait period for health coverage for new residents to the province. The petition, which calls on the BC Medical Services Commission to permanently eliminate the “wait period” policy, is based on new research by CGSHE’s IRIS Project and Sanctuary Health that shows the policy disproportionately harms racialized im/migrant women and their families. Published in the peer-reviewed journal BMJ Open, the research draws on interviews with women who were im/migrants to British Columbia, as well as service providers who support them. The findings expose serious inequities in Canada’s health care system that endanger the health and wellbeing of im/migrant women in BC.

“Mandatory wait periods for health coverage add to inequity and stigma, and increase negative health and social outcomes for im/migrant women. Our findings show this results in unmet health care needs, socioeconomic stressors, and negative outcomes in pregnancy and for children’s health,” said Maggie Hamel-Smith Grassby, CGSHE researcher and lead author. “BC’s three-month wait policy shows that we’re lagging behind the rest of Canada by maintaining this xenophobic exclusion that uses resource scarcity to pit residents against non-residents.

One study participant described spending her family’s last few hundred dollars on a doctor’s visit and medication for her sick child, leaving them with nowhere to sleep and little money for food. Another participant told of hearing her daughter cry out in pain at night. “I would cry with her until the morning. The doctors were refusing to see her. Coming to Canada had become a negative experience for me because I was worried about losing my daughter.”

The research highlights the ways in which gendered racism and exclusionary immigration policy impact Canada’s health system by producing disproportionate harms for im/migrant women, explained Dr. Shira Goldenberg, CGSHE faculty member and Principal Investigator of Evaluating Inequities in Refugee & Immigrant Women’s Sexual Health Access. “The hardships caused by BC’s mandatory wait period are unnecessary and heartbreaking. The women developed mistrust and felt ‘undeserving’ of care. They shouldered the financial burden of unexpected costs, which meant impossible choices between basic survival and health care.”

The study also found that community-based organizations helped im/migrant women mitigate the stress and isolation created by the three-month wait policy. “Community based organizations provided support to fill out paperwork and access services, which helped reduce delays in qualifying for health care,” Hamel-Smith Grassby said. “This support was life-changing for im/migrant women and their families to be able to receive affordable and appropriate care.”

The denial of health coverage on the basis of immigration status results in discriminatory and inhumane gaps in health care for im/migrants, explained Dr. Goldenberg. “That’s why we are calling for the immediate and permanent repeal of BC’s exclusionary wait policy.” Hamel-Smith Grassby added: “Policy reforms towards full healthcare for all, regardless of immigration status, are urgently needed to affirm the health and human rights of all.”

The research adds to persistent call from migrants, health care workers, community organizations and unions for a permanent end to the wait period. In March 2020, the BC Medical Services Commission temporarily rescinded the policy, only to reverse that decision several months later. “In their response to COVID-19, the government demonstrated that they could end this exclusionary policy with the stroke of a pen, and they also revealed their twisted priorities by rushing to reinstate the wait period during an escalating global pandemic,” said Omar Chu, of Sanctuary Health. “Now that we’re in the thick of t the fourth wave, it’s time to eliminate this discriminatory and harmful policy once and for all.”

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