RAMQ told to give health coverage to pregnant immigrant woman
Published on: May 2, 2016 | Last Updated: May 2, 2016 9:25 PM EDT
A last minute reprieve is in the works for a Montreal-area couple scrambling to find $12,000 to pay a doctor and hospital to deliver their baby because of a bureaucratic glitch over a working visa.
Originally from China, Jackie (Liang) Zhong has been studying in Canada since 2008, and working full time in Brossard for the past two years on an open work visa. Her medical coverage runs out this month because when she renewed her Canadian visa, she was placed in a different category — going from graduate student to family class, which RAMQ, the provincial health insurance board, does not recognize as eligible for health coverage.
Last week, Quebec Health Minister Gaétan Barrette personally intervened in the case.
Using his discretionary powers, Barrette demanded RAMQ issue Zhong a temporary medical card.
Jason Lizotte and Jackie Zhong, who are expecting a baby in August, say they are tremendously relieved about no longer having to scramble for money to pay for the birth.
But the couple is also frustrated about the protracted two-month battle with RAMQ over rights they say are enshrined in the Canada Health Act.
“We’re both cautiously relieved, but I’m surprised it took so long,” said Lizotte, 32, a territory manager for Provigo, eastern Canada.
Lizotte said he has grave concerns for other immigrant women in Quebec and families who may not have public health insurance because of similar bureaucratic grey zones over work permits.
“We’re waiting to have the (medicare) card in our hand,” he said. “But it doesn’t change the (Quebec) guideline, which is unreasonable.”
The couple met as students at Brock University in St. Catharines, Ont., he was in math, she was in accounting. Zhong became Lizotte’s tutor in Mandarin. When her studies ended, Zhong got an open graduate work permit. They married after moving to Quebec in May two years ago when Lizotte got the job at Provigo. Zhong worked full time as a cashier at one of the stores, and as an accountant on tax returns during tax season. After the move, both got the provincial health card issued by RAMQ, the “carte soleil.”
Also, Lizotte applied to sponsor his wife as a permanent resident. The couple had bid on a three-bedroom house in February to accommodate their growing family, when they learned that RAMQ was planning to stop covering Zhong’s health care even though she’d had insurance from them for nearly two years. The news dropped like a bombshell, Lizotte said: “It was a nightmare.” They immediately withdrew the bid on the house.
“RAMQ cancelled my wife’s health coverage, and we’re expecting a child,” said Lizotte who began an exhausting paper trail campaign in an attempt to reverse RAMQ’s decision. He went to his local member of Parliament’s office where he got a sympathetic ear, but was told there was nothing they could do because health is a provincial matter.
He went to his local MNA — which happens to be Barrette’s office — and staff there contacted RAMQ on his behalf, but nothing came of it.
“My wife Jackie has a legal open work permit that is a valid document from Immigration Canada that entitles her to be in Canada, and she is ordinarily present in the province of Quebec … for about two years now. She isn’t a tourist, transient nor a visitor,” Lizotte wrote health administrators, politicians and journalists, citing the universality of the Canada Health Act as it pertains to residents. “I thought it was some crazy rule they overlooked that would be resolved …”
All Canadian work permits were not created equal, said RAMQ spokesperson Marc Lortie, who would not comment on an individual case.
Ontario, Alberta, and New Brunswick extend health coverage to those with a valid work permit who are awaiting permanent residency.
But what about Canada’s obligation? What are Zhong’s rights under the Health Act? Andrew MacKendrick, press secretary for federal Health Minister Jane Philpott, referred a reporter back to Quebec’s eligibility criteria.
“It is the provinces and territories that are responsible for determining their own minimum residence requirements with regard to an individual’s eligibility for benefits under its health insurance plan,” MacKendrick replied in an email.
Those who work with refugees and immigrants say it’s aberrant that the same work permit results in differing health coverage in different provinces. That is, until last week when Barrette intervened.
Barrette asked RAMQ to overturn its current guidelines to extend eligibility to those holding a valid work permit for a period longer than six months, with documents showing that they have applied for permanent residence, and have full-time employment.
Maison Bleue, a health centre for vulnerable women, provides free blood tests, ultrasounds and the services of a doctor and doula for about 10 pregnant women each year — refugees who were refused status, immigrants and students without health care — but fees for the birthing doctor and hospital are extra. They run in the thousands of dollars depending on the hospital and on whether the birth is simple or complicated.
“We have 10-12 women a year but we could take 50,” said Anne-Marie Bellemare, a social worker at the centre. “We try sometimes to (normalize) their status, write letters and go with them to immigration, and have lawyers that work with them to ask for (exceptions on) humanitarian (grounds) … or try with RAMQ to reverse their decision but the rules are very difficult.”
Lizotte and Zhong say they can now focus on preparing for their newborn rather than fighting bureaucracy