Health care extended to children of immigrants in Quebec with uncertain status, closing long-standing gap

More than 4,000 children of immigrants living in Quebec could finally be able to get free health care from the province's health insurance plan, under legislation tabled Thursday by the government.

The situation had been decried by human rights groups, and the Quebec ombudsman

People take part in a demonstration outside Quebec Premier Francois Legault’s office in Montreal, Saturday, Nov. 21, 2020, where they called on the government to give permanent residency status to all migrant workers and asylum seekers.The COVID-19 pandemic continues in Canada and around the world. THE CANADIAN PRESS/Graham Hughes (Graham Hughes/The Canadian Press)

More than 4,000 children of immigrants living in Quebec could finally be able to access the province's health insurance plan, under legislation tabled Thursday by the government.

For decades, children of parents who had a precarious or unsettled immigration status were not covered by the Régie de l'assurance maladie du Québec.

That meant that even some children born in Quebec, and who were thus Canadian citizens, were unable to benefit from the province's free, universal health-care system.

The situation has been criticized by several human rights groups and, more recently, by Quebec's ombudsman.

But this summer, Premier François Legault vowed to pass legislation to extend health-care coverage to children of parents whose immigration status is precarious. On Thursday, his health minister, Christian Dubé, made good on that promise.

"Our desire is to improve in a significant and sustainable way the health of children who are on Quebec soil," Dubé said at a news conference in Quebec City.

Quebec Health Minister Christian Dubé sponsored the bill, which was tabled Thursday in the National Assembly. (Ryan Remiorz/The Canadian Press)

Under the legislation, Bill 83, children accompanying a parent who has a study visa, a visa longer than six months or a work visa not tied to a specific job will be able to access provincial health and drug insurance.

It is estimated as many as 4,350 children currently living in Quebec will benefit from the change if the bill passes. 

Closing the loophole

The gap in insurance coverage can be traced to RAMQ's rigid interpretation of Quebec's Health Insurance Act, which says that someone needs to be "domiciled" in Quebec to be insured.

The RAMQ has tended to assume that children are domiciled with their parent, regardless of where they were born. If the parent wasn't eligible to be insured either by the province, or the federal government, then RAMQ often decided the child couldn't be either.

In 2001, the Parti Québécois government amended the Health Insurance Act, attempting to expand health insurance to all children born in the province. The reform, though, failed to change RAMQ's interpretation. 

One of the advocacy groups that had been lobbying for the change, the Early Childhood Observatory, welcomed the bill tabled Thursday.

"This is excellent news, especially at a time when the pandemic has exacerbated social inequalities. Living conditions are more difficult than ever for migrant families with precarious status, who have been hard hit by the current crisis," the group said in a statement.

But the group also expressed concerns the legislation, as it's currently drafted, will continue to exclude some children, such as those whose parents are waiting for the renewal of an expired residency permit. That process can last years.

The observatory is also asking the government to offer pregnancy monitoring for migrant women with precarious status.