Fight in Quebec for Free Health Care Coverage for Workers with Precarious Migratory Status and Their Families - Diane
Johnston - 
Quebec has
been the stage of a decades-long battle for free health care coverage
for workers with a precarious migratory status and their families.
In Quebec, successive governments have all intentionally
violated the intent of Quebec's Health Insurance Act
as well the Convention on the Rights of the Child, adopted by the
United Nations General Assembly in 1989, to which Canada is a signatory
and which Quebec has endorsed through an order in council. Their
violation of Quebec, Canadian and international law goes so far as to
refuse coverage to the children of workers with a precarious migratory
status born in Quebec, despite the fact that they are Canadian
citizens, while the federal government turns a blind eye. These
children are deprived of their right to health care through the refusal
of coverage for them by the Quebec Health Insurance Board (RAMQ), which
is directly accountable to the Minister of Health and Social Services.
Adding insult to injury, in 1992 under the Quebec Liberal
government, a 200 per cent surcharge for medical fees was applied and
continues to be billed to the parents of these children. Besides
Quebec's Ombudsman, many advocacy groups have been fighting for the
right to health care for all children living in Quebec including
Doctors of the World Canada, the Quebec Immigration Lawyers Association
(AQAADI), the Early Childhood Observatory, the Caring for Social
Justice Collective, the Quebec Human Rights and Youth Rights
Commission, the Roundtable of Groups in the Service of Refugees and
Immigrations (TCRI) and the list goes on. Presently,
a class action law suit awaits a hearing date at Quebec's Court of
Appeal on behalf of a couple, their daughter and all children who are
Canadian citizens living in Quebec who have been denied access to
health coverage through the RAMQ as a result of their parents'
immigration status. The action, first filed on July 9 of last year at
the Superior Court, alleges that the exclusion of these children is
contrary to Quebec's Health Insurance Act and that
it violates the fundamental rights of these Canadian children,
including their rights to life, security and integrity as protected by
the Canadian Charter of Rights and Freedoms and
the Quebec Charter of Human Rights and Freedoms.
They further argue that this government practice is discriminatory.
Medical fees of close to $7,000 were billed to the mother of
the child upon giving birth. An additional fee of $2,500 was also sent
for the night the baby spent in hospital after her birth. Shortly
thereafter the child had health issues requiring hospitalization,
resulting in a new bill of close to $15,000. No refund is forthcoming
as access to the RAMQ was refused for the baby, despite the fact that
she is a Canadian citizen. Such practices are "completely illegal" says
the couple's lawyer. Damages and interest are also being claimed for
all families that are part of the class action lawsuit targeting the
Ministry of Health and Social Services, which was contested by Quebec's
Attorney General. Then surprisingly, on December 10
of last year, on the occasion of International Human Rights Day,
Christian Dubé, Quebec Minister of Health and Social
Services, introduced Bill 83, "An Act respecting mainly the
health insurance plan and presscription drug insurance plan eligibility
of certain children whose parents' migratory status is precarious".
Having received royal sanction on June 11, the legislation is to go
into effect by government decree between now and the end of September.
Through the new legislation, most children in Quebec of
parents with a precarious migratory status will finally be provided
health care coverage free of charge. This includes all children born in
Quebec as well as children accompanying their parents who have a study
permit, a visitor's permit longer than six months, a work permit not
tied to a specific employer, or in an irregular immigration situation,
in other words, without legal status. A little over
a month after the bill had been introduced, on January 18 of this year,
the Superior Court issued a judgment granting a motion from the
Attorney General of Quebec for declinatory exception seeking the
dismissal of the Class action. The Superior Court concluded that it did
not have jurisdiction to hear this class action, declaring that
applicants should instead apply to the Administrative Tribunal of
Quebec. So on the one hand, the Legault government
is expanding health care coverage for most children of parents with
precarious migratory status for so-called reasons of equity and
fairness and on the other is fighting in the courts against
compensating the parents of children deprived of their basic human
right to health care, not to mention the denial of that right for
themselves even during the COVID-19 pandemic. Furthermore,
since May of 2018, Quebec's Ombudsman, Marie Rinfret, has been decrying
the fact that the RAMQ has been using "a restrictive, if not a faulty,
interpretation of the Act and the Regulation." She has noted that the
RAMQ "correlates their eligibility with their parents' migratory
status" and that these children can be deprived of the health and
social services they need if their parents cannot afford the costs."
In her view, the solution lies in applying the Act as written,
as it "presumes an interpretation of the notion of a child born in
Quebec and settled in Quebec that respects the legislator's intention
to distinguish children's status from their parents' migratory status
for public health plan eligibility purposes." All
of this begs the question: Why is the Legault government implementing
amendments to not only the Quebec Health Insurance Act,
and the Act respecting prescription drug insurance,
but also the Regulation respecting eligibility and
registration of persons in respect of the Régie de
l'assurance maladie du Québec and the
Regulation respecting the basic prescription drug insurance plan?
The Legault government and those before them seem intent on
following the same path as their federal counterparts, in this case
through the violation of international, federal and Quebec law and
charters and increasingly adopt regulations they can easily modify
through dictate. On the issue of the deprivation of
rights, the Legault government, just like its federal counterpart, is
on the defensive and we must continue to hit hard, until such time as
permanent residency status is granted to all migrants with a precarious
status. The dictum "Good Enough To Work, Good Enough To Stay" is a
principle we fight for and defend. Permanent residency in this case
would also give all migrants with precarious status access to health
care. At the same time, we must remain vigilant
with regard to the manoeuvres being made by both levels of government
and not be taken in by them. With justice on our
side, the battle for rights must be played out on all fronts, including
in the election arena both federally, most probably this year, as well
at the Quebec level next year. Our battle cry must
be for our own empowerment as human beings and our right to determine
our own affairs. Nothing short of that will
guarantee our success, so let's all join in!
This article was published in
August 2, 2021 - No.
64
Article Link:
https://cpcml.ca/WF2021/Articles/WO08643.HTM
Website: www.cpcml.ca
Email: editor@cpcml.ca
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