New research calls for urgent policy reform to ensure health access & human rights for immigrants

About the Letter

In partnership with Sanctuary Health, the Centre for Gender & Sexual Health Equity sent an open letter to the BC government, calling on our elected officials to immediately end the costly and discriminatory policy that requires new immigrants to BC to wait three months for health insurance. The letter, signed by 19 unions, advocacy groups and community organizations and published in the Burnaby Beacon, is based on a growing body of research that shows the policy disproportionately harms immigrant women and their children, and violates their human rights. The letter follows a petition calling on the government to repeal the policy, which was signed by more than 400 individuals and groups.

Read our Letter

Honourable Premier John Horgan
Shirley Bond, Interim Leader of the Opposition BC Liberal Party

December 17, 2021

RE: New research confirms urgent need to repeal BC’s mandatory waiting period for provincial health insurance, as harmful to immigrants’ health and human rights

Dear Government Leaders,

Recently published research1 by the Centre for Gender and Sexual Health Equity at the University of British Columbia highlights the ways in which British Columbia’s Commencement of Enrolment policy—which includes a mandatory three-month wait period to receive provincial health insurance (the Medical Services Plan, MSP) for immigrants from outside Canada—is disproportionately harming racialized women and their children. The research, affirming longstanding community concerns, confirms the urgent need for this policy to be amended or repealed immediately.

Research shows that this health insurance waiting period causes substantial health consequences for immigrants—specifically for infants, children, people of colour and during pregnancy.1 Providing timely access to care during pregnancy and for infants is critical to avoid negative and potentially devastating outcomes and costs associated with delayed or foregone essential health care for immigrant women and their children. This policy worsens health inequities and ultimately increases health spending, costing more than if coverage were provided to immigrants on arrival.2 Because of this policy, new residents in BC are often forced to live with increasingly serious health issues or make impossible choices between food and housing, or health care coverage for themselves or their sick children.

Immigrants have faced severe health inequities during the COVID-19 pandemic, amplifying concerns related to gaps in health insurance coverage amongst immigrants. Research shows that immigrant and racialized communities have been disproportionately impacted by COVID-19.3,4,5,6 Immigrants are over-represented in frontline occupations that have been hard-hit by COVID-19, including food production and health care.7 Importantly, recent population-based research in BC has shown that immigrants—particularly those holding work permits and other temporary statuses—face much lower access to COVID-19 testing and COVID-related healthcare than Canadian citizens.8

British Columbia’s wait period policy violates multiple international human rights conventions and is in stark contrast to Canada’s purported commitment to universally accessible and inclusive health care.9 In fact, new CGSHE-UBC research shows that 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. Amidst the global pandemic’s fourth wave and the spread of new COVID-19 variants, health access for migrant communities disproportionately impacted is all the more urgent. We urgently call on the BC Government and the Medial Services Commission to immediately and permanently repeal the wait period for all residents coming from outside of Canada to ensure access to health for all. Legal and policy groups, unions, and civil liberties organizations from across BC, along with hundreds of individuals call for an immediate end to this costly, discriminatory, unjust and unnecessary policy.10


This letter was published in the Burnaby Beacon.


Centre for Gender & Sexual Health Equity, University of British Columbia

Sanctuary Health Vancouver

BC Civil Liberties Association

BC Federation of Labour

BC General Employees Union

BC Health Coalition

BC Nurses’ Union

BC Poverty Reduction Coalition

Canadian Centre for Policy Alternatives – BC

Damayan Society for Migrant Worker’s Education & Resources

Health Sciences Association

Hospital Employees Union

Living In Community

Migrante BC

Migrant Workers Centre

Pivot Legal Society

SWAN Vancouver

Vancouver & District Labour Council

West Coast LEAF

  1. Hamel-Smith Grasby et al. 2021. Qualitative evaluation of a mandatory health insurance ‘wait period’ in a publicly funded health system: understanding health inequities for newcomer im/migrant women. BMJ Open.
  2. Sanctuary Health. 2020. Policy study of the “three month wait” in BC.
  3. Public Health Agency of Canada. CPHO Sunday Edition: The Impact of COVID-19 on Racialized Communities. 2021 [cited 2021 Jun 2].
  4. Guttmann A, Gandhi S, Wanigaratne S, Lu H, Ferreira-Legere LE, Paul J, et al. COVID-19 in Immigrants, Refugees and Other Newcomers in Ontario: Characteristics of Those Tested and Those Confirmed Positive, as of June 13, 2020. ON, Canada: ICES; 2020 Sep [cited 2021 May 26].
  5. Sundaram ME, Calzavara A, Mishra S, Kustra R, Chan AK, Hamilton MA, et al. Individual and social determinants of SARS-CoV-2 testing and positivity in Ontario, Canada: a population-wide study. CMAJ. 2021 Jan 1 [cited 2021 May 3].
  6. Tuyisenge G, Goldenberg SM. 2021. COVID-19, structural racism, and migrant health in Canada. The Lancet.
  7. Goldenberg, S & Wiedmeyer, M. 2020. We need to ensure universal health care includes migrant workers during and beyond COVID-19. The Province.
  8. Wiedmeyer, M et al. 2021. SARS-CoV-2 testing and COVID-19 related primary care use among people with citizenship, permanent residency, and temporary immigration status in British Columbia: Cross-sectional analysis of population-based administrative data. BMJ.
  9. Chen, YYB. 2015. Extending health care entitlement to lawful non-transient international migrants: Untapped potential of the universality principle in the Canada Health Act. University of British Columbia Law Review.
  10. Centre for Gender & Sexual Health Equity. 2021. End BC’s dangerous and costly wait period for immigrants to receive health care.

Download the open letter here

Download the media release here