In March 2024, BC’s Period Poverty Task Force submitted its final report to the Minister of Social Development and Poverty Reduction. The report proposes sustainable approaches to period poverty in BC. One notable short-term recommendation is to abolish the Medical Services Plan (MSP) 3-month wait period for all refugees, international students, newcomer immigrants, and seasonal migrant workers. This policy has a wide range of consequences for both those affected and the provincial health system overall.

Written by Brenna Whalley, Mary Yung, and Alex Brun

What is the 3-Month Wait Period? 

To enroll in  the Medical Services Plan (MSP) health insurance coverage , new residents must wait for the remainder of the month they arrive in BC plus two calendar months afterwards.

Consequences of the 3-Month Wait Period 

Research has shown that the 3-Month Wait Period on has four major consequences on newcomer im/migrant women in BC:

A perpetuation of im/migrant marginalization and mistrust in the health system 

The mandate for newcomers to wait 3 months to access health coverage is perceived as arbitrary, with little logic known to back up the policy. Those affected by the policy report that it perpetuates the public’s misconception that im/migrants are only taking resources from Canada, ignoring any of their contributions. Additionally, health access is a human right and this policy dehumanizes populations, contributing to the growing mistrust in our provincial health system. 

An increased administrative burden and out-of-pocket costs on newcomers 

Study participants commented that they were often unaware of the wait period prior to their arrival, and the various policy exemptions make eligibility difficult to navigate. Additionally, any health services required during the first 3 months are a large out-of-pocket expense for the patient. A lack of health coverage increases financial burden or may result in unmet health needs, due to unaffordability. 

Exacerbation of negative health outcomes

The lack of health coverage particularly affects contraceptive access and prenatal care. This means many family plans are affected, increasing the occurrence of unintended pregnancies. Additionally, those who arrive pregnant or get pregnant shortly after, face significant barriers to necessary prenatal care. This can result in ill health outcomes for the pregnant person and/or their fetus. Furthermore, many children’s illnesses are left unmet as they are unable to receive necessary care or medication. 

Over-reliance on community networks and organizations 

Study participants highlighted their reliance on informal support within their communities, found through social media or by word of mouth. Community networks connected newcomers with community-based organizations to help mitigate ill-health during the wait period. However, these organizations have insufficient resources to completely make up for a lack of MSP coverage. 

Unfair burden during stressful transitions

While there are certain exceptions to the waiting period, applying for an exception places an unfair burden on immigrant, migrant, and newcomer families to ‘prove’ their deservedness to care. Residents must navigate the bureaucratic steps necessary to report sources of income, monthly expenses, and employment status. 

They must also provide a letter from a treating physician or hospital outlining “the specifics surrounding diagnosis or treatment that would constitute an acceptable reason for the waiting period to be waived” (British Columbia Period Poverty Task Force, 2024, p. 41). To qualify for a waiver, the patient’s medical condition must have been diagnosed in the wait period and must be financially devastating; when it meets these requirements, the committee also considers the seriousness of the condition, whether the person was able to access required health care services during the wait period and whether private insurance was obtained/obtainable for the wait period. 

The government recommends that migrants obtain private insurance during the wait period, but will not grant waivers to the wait period to individuals with pre-existing conditions. Private insurance also will not cover pre-existing conditions, meaning that the wait period policy discriminates against people with disabilities, forcing them to take on huge debts to obtain medical care.

The 3-Month Wait is an additional burden during an already stressful transition period for immigrants, migrants, and newcomers. Furthermore, the exclusionary policy only perpetuates health inequities and unmet health needs in vulnerable populations.  

Busting the Myth: The Waiting Period Saves the Health System Money

Despite a common misconception, research has reported “no evidence of cost-savings - only cost delay, and in some cases cost exasperation” (British Columbia Period Poverty Task Force, 2024, p. 41). Excluding people from health coverage may result in conditions worsening during the waiting period and thus leading to a higher burden on the system once they are able to receive care.

The 3-month wait period directly opposes achieving health equity and justice. The BC Health Coalition supports the  BC Period Poverty Task Force’s recommendation for to permanently repeal the 3-month residency-based MSP waiting period for all refugees, international students, newcomer immigrants, and seasonal migrant workers.  

Download our fact sheet!

Who is the Period Poverty Task Force? 

In 2022, the Government of British Columbia, in partnership with United Way BC, commissioned the Period Poverty Task Force to address the goal of ending period poverty and reducing stigma surrounding the topic. The task force comprised diverse individuals, appointed with considerations of geographical location, knowledge on the issue, and lived experience. Indigenous ways of knowing, perspectives from people living with disabilities, and experiences of those with diverse genders were prioritized during the development of the Task Force’s Final Report. 

The Task Force chair was Nikki Hill, and members included A.J. Lowik, Jackie Jack, Kate Fish, Lori-Ann Armstrong, Tiffany Ottahal, and Zeba Khan. Over 18 months, the group met regularly to propose sustainable solutions to period poverty. Their final report includes short, medium, and long-term recommendations to help reach the ultimate goal. The group’s work was supported by four reference groups that included businesses, community-based organizations, BC-based menstrual equity advocates, and people with period poverty lived experience. These reference groups ensured the report was created with diverse, intersectional perspectives.

References

British Columbia Period Poverty Task Force. (2024, March). Period Poverty Task Force FInal Report. United Way British Columbia. https://uwbc.ca/program/period-promise/

Grassby, M. H.-S., Wiedmeyer, M., Lavergne, M. R., & Goldenberg, S. M. (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, 11(8), e047597. https://doi.org/10.1136/bmjopen-2020-047597

Health, M. of B. (2023, April 5). Coverage Wait Period—Province of British Columbia. Province of British Columbia. https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/msp/bc-residents/eligibility-and-enrolment/how-to-enrol/coverage-wait-period

United Way BC. (2022, May 27). Period Poverty Task Force. United Way British Columbia. https://uwbc.ca/stories/2022/period-poverty-task-force-announced-by-government-of-bc-in-partnership-with-united-way-british-columbia/