BC to stop funding COVID-related care for people not eligible for MSP

UPDATE: The BC government has walked back a decision to cut off COVID-related care for new residents of the province who are not eligible for coverage under the Medical Services Plan (MSP), hours after Burnaby Beacon published its report on the topic. You can find the latest update here.

Beginning Nov 1, BC’s government will stop funding most COVID-related care for new BC residents who aren’t yet eligible for coverage under the Medical Services Plan (MSP), Burnaby Beacon has learned.

New immigrants are subject to a three-month waiting period before they’re eligible to apply for MSP and are encouraged to purchase private insurance in the interim to avoid high medical bills if they require care.

The Medical Services Commission waived that waiting period on March 1 last year when the pandemic was ramping up—but reinstated it several months later, except in cases where a patient needed COVID-related care.

But that coverage is being cut Oct 31, the Ministry of Health told the Beacon in an emailed statement.

And while people not covered by MSP do still have access to provincially-funded COVID laboratory tests for now, that access will also end on April 30, 2022. Access to COVID vaccinations is not impacted.

The Ministry told the Beacon that “based on the stage of BC’s Restart, as well as utilization rates, it was recommended that the COVID-19 generic Personal Health Number remain in place, but limit coverage to the laboratory test”—but it didn’t say who had made that recommendation.

“Non-MSP eligible individuals in BC who need health care services will not be refused care and can receive the services they require to ensure their health care needs are met,” the Ministry said.

“However, unless alternative health insurance has been obtained, the cost of such services is the responsibility of the individuals involved.”

An “unconscionable” shift

Community advocacy groups told the Beacon they weren’t made aware of the policy change.

“I’m shocked right now,” said Sanctuary Health member Omar Chu.

“I can’t believe that the province would make a decision that would be so harmful to our society as a whole in BC. It makes people even more afraid than they already are, to seek medical care for COVID-19. It is unconscionable … especially as we’re hoping to avoid a fifth wave of COVID-19 and when we made such progress on access to vaccines and other issues.”

The updated policy on COVID-related care is not posted publicly on the Ministry of Health’s web page dedicated to the MSP response to COVID.

However, Chu said he wasn’t surprised that the policy hadn’t been broadly announced.

“I would be confident that they wouldn’t want to tell us because they know that we’ll be protesting on the streets and fighting this.”

The NDP government did not respond to an inquiry as to why the change wasn’t publicly announced, saying instead that changes would be updated on the website. The BC Liberals and BC Greens told the Beacon they were also unaware of the shift.

BC Greens leader Sonia Fursteneau said she felt “agitated” upon hearing the news.

“I was quite surprised and dismayed to hear this. We are still seeing hundreds and hundreds of cases a day, we’re seeing hospitals bearing a heavy burden from COVID. And the notion of once again removing support for the most vulnerable, marginalized people in BC at a time like this is astonishing,” she said.

“What was the decision-making process to arrive at this decision? What informed this decision? This government, and the minister of health should absolutely be providing the public with his explanation and his justification for a decision like this.”

‘Deincentivization’ of seeking care

Chu said the policy will endanger lives, especially those of racialized recent immigrants and those in precarious work conditions, who will be afraid to seek care when they really need it for severe cases of COVID.

“ People are already afraid to go to a hospital and access health care. I’ve told people before that have been scared to go—‘don’t worry, there’s a policy in place. … You won’t be charged medical bills for the suspected and confirmed cases of COVID-19, and it’s important that you seek care,’” he said.

“Now I can’t say that to people anymore. People are going to be afraid to go, and it’s going to put lives at risk.”

Dr Shira Goldenberg, with the UBC Centre for Gender and Sexual Health Equity, agreed with Chu. She said people who don’t have health insurance are likely put off or avoid accessing COVID-related care altogether because of the possible costs, even when they urgently need medical attention.

Goldenberg called the policy change “unacceptable” and a violation of human rights.

“A policy like this will make things worse—it will simply add financial strain and barriers to care. We should anticipate seeing worse health outcomes as a result. So if that’s the province’s aim, then of course that policy would make sense,” she said.

“But if the aim is to save lives, and to create equity in health and in healthcare, then this decision is the opposite of what needs to be done. We need to see expanded coverage, not coverage being withdrawn based on a resource scarcity model.”

Appeals process

The Ministry of Health said in an emailed statement that the intent of the permanent three-month waiting period is “to discourage individuals that are non-residents from seeking medical treatment in B.C. and then returning to their usual place of residence.”

It also said there is an appeals process for people who incur unexpected medical costs during their first few months in BC, where the cost can be waived if deemed appropriate.

But the website that guides new British Columbians through that process is upfront about the fact that there are few exceptions.

“The costs of health care received during the wait period must meet the requirement of being financially devastating,” the website reads.

Goldenberg recently released a paper in medical journal BMJ open looking at the impacts of the waiting period—in that paper, she said what’s touted as a cost-saving measure actually just delays costs because people wait until they are covered to seek care.

Goldenberg’s paper also called the waiting period xenophobic and said it breeds mistrust and stigma in the province’s healthcare system.

She said removing access to care for some for an illness that’s causing a global pandemic is just another example of a problematic policy that makes people feel unsafe and unwelcome.