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A ruling denying a cancer patient’s bid to keep their health-care coverage in Manitoba after turning 18 is a symptom of broader systemic barriers preventing immigrants from accessing care, advocates say.
The Manitoba Health Appeal Board rejected a request from a high school student with leukemia to keep their health benefits because current regulations won’t allow it until they get a work permit.
Health Minister Uzoma Asagwara said they’ve been directly in contact with the family for several months and that the province will continue to support them, calling the situation “heartbreaking.”
“Their child will continue to receive the highest quality care possible in Manitoba,” Asagwara told reporters Wednesday. “This family is not going to have to pay.”
Advocates said the situation speaks to a broader issue of people being denied health care in Manitoba because of their immigration status.
“We have, in some ways, a two-tier health-care system already in Manitoba,” said Noah Schulz, provincial director of the Manitoba Health Coalition.
“Manitoba is worst in the country in terms of access to health care for international students. It’s the most expensive in terms of the private options. There are serious gaps there.”
Not stable enough to travel to home country
The appeal board ruling from June said the youth, a child of a work-permit holder, was diagnosed with B-lineage acute lymphoblastic leukemia in February and that their health had deteriorated to the point they couldn’t walk or eat and required “daily oxygen along with other medical interventions.”
The decision did not contain details about the youth, such as their country of origin or gender, except for their age.
The pediatric oncologist who was treating the youth wrote a letter saying they couldn’t move back to their home country for treatment for at least one more year because their condition was not stable enough.
The family appealed to keep the youth’s health benefits until they were well enough to travel on compassionate grounds, the decision said.
A hearing was held just over a week before the youth turned 18, at which time their coverage would expire under current regulations.
The board said high school students with migrant status must obtain a work permit for their health benefits to continue after reaching the age of majority.
The processing time estimate for work permit applications filed within Canada was more than five months as of this week.
Extending the coverage period for students “is a legislative policy decision and falls outside the purview of this board,” the decision said.
“Regrettably, there are no provisions … that would allow health benefits to be extended.”
The teen and their parents came to Canada in 2023. The board said the teen was a “high-achieving, honour-roll” student who had been accepted into university for the fall.
The board said it hoped all parties involved explored possible solutions that could “ease the significant financial and emotional burden facing the family.”
Of 39 decisions published by the Manitoba appeal board so far this year, 10 were dismissals where the appellants’ immigration status made them ineligible for coverage, including the ruling on the young cancer patient.
The dismissals make up half of insurance-related decisions.
The board has said in previous rulings legislation does not allow it to consider humanitarian or compassionate grounds when making decisions.
‘Unjust gaps’
Public health coverage eligibility for immigrants varies from province to province.
Schulz said jurisdictions such as Alberta have wider eligibility than Manitoba.
“People who live and work here, who aren’t essentially tourists … should have health coverage,” he said.
“Others who can’t access health care because they don’t have a health card, perhaps because of lack of housing or because of simply having the wrong work permit or immigration status — those are all unjust gaps in coverage that limit [a] truly universal public health-care system.”
Tracy Glynn is one of the founding directors of the Fredericton, N.B.-based Madhu Verma Migrant Justice Centre and national director of operations for the Canadian Health Coalition. She said she hopes the case exposes the obstacles immigrants face when trying to access care across the country.
“Medicare … was supposed to be universal, and it was supposed to be expansive,” Glynn said.
“Instead, we’ve seen a situation … of health-care cuts, of scapegoating of migrants, too, for the health-care crisis, for the housing crisis — and that needs to be challenged.”
Glynn called on the Manitoba government to reduce barriers — including making good on a promise to restore public care for international students.
A report she authored in January found the province was only one of three jurisdictions where international students were not covered, along with Ontario and Yukon.
“People who are denied timely access to health care are going to end up in our ERs, and they’re going to end up being more costly patients,” Glynn said.
“So, there’s the moral arguments to be made here, but there’s also the economic arguments.”