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Moving to N.L. from another province? You might not get health care

At least three Canadians say they're struggling to access medical care, even though they're here to stay.

Some residents are fighting for MCP cards under a policy that won't cover students

Newfoundland and Labrador resident Charlotte Morton needs gallstone surgery, but the province refuses to give her an MCP card. As a result, she's living with a condition that could lead to sepsis. (Sherry Vivian/CBC)

Charlotte Morton might have been raised on another coast, but she married a Newfoundlander, works in St. John's and rents a house in Airport Heights.

She has no plans to move; Newfoundland is home for Morton in every sense of the word.

Except, that is, for one: Medical Care Plan policy won't consider Morton a resident, she says, leaving her struggling to access basic care.

"I work here, I pay taxes here, my children go to school here," Morton told CBC News. "I couldn't be more entrenched into the local community in terms of where my social network is, but because I was living in B.C. before I came here, I'm not considered a resident."

Under the  Canada Health Act, "home" provinces must cover a Canadian resident who settles elsewhere in the country for three months.

I work here, I pay taxes here, my children go to school here.- Charlotte Morton

After that, it's up to the new province — in this case, Newfoundland and Labrador — to take over and start shelling out for services.

But MCP told Morton she's ineligible for coverage as long as she attends school, despite Morton making it clear that she does not intend to return to British Columbia after her studies.

Angelica Lauzon and her partner, Stewart Walker, have been refused health-care coverage in Newfoundland and Labrador, despite having moved to the province permanently. (Malone Mullin/CBC)

Morton, an instructor and PhD student at Memorial University, said she has requested coverage four times since 2012 but was refused on each occasion, leaving her on the hook for specialist bills until B.C. reimburses her.

She can't afford that, she said. Instead, she's stuck waiting for B.C. to approve those expenses, including surgical gallstone removal.

But B.C. hasn't yet agreed to cover the procedure in Newfoundland, meaning Morton would need to spend time and money to travel across the country.

So for now, she waits, hoping her condition doesn't cause sepsis and still fighting to have the extraction performed in Newfoundland without facing hefty up-front costs.

The bureaucratic tangle has left Morton neglecting her health.

"I've put off dealing with things," she said.

Regulatory hole

Under the province's  Medical Care and Hospital Insurance Act, a "resident" of a province is someone who simply "makes his or her home" in Newfoundland and Labrador. But it doesn't include students or their dependents, as long as they're covered by their home province.

An MCP official told CBC News that as policy, the province does not accept any application that references studying in Newfoundland.

Yet some provinces, including British Columbia, won't cover students who leave and don't intend to return after graduation.

The resulting regulatory gap left Angelica Lauzon and her partner, Stewart Walker, without any coverage at all earlier this month.

Lauzon said she made all the necessary calls to each health authority before moving to St. John's from Victoria in September. But when she tried to submit her MCP application, she was told that because her partner was in school, she wouldn't be eligible either.

Health Minister John Haggie says he wants to open up eligibility for MCP coverage. (Katie Breen/CBC)

Lauzon explained they had moved to Newfoundland for good and asked to fill out the form again. At that point, she was told they would be charged with fraud if they attempted to reapply while Walker remained a student.

Their home province, also B.C., issued a letter to the couple stating they wouldn't be protected by B.C. insurance since they did not intend to return.

Their three-month grace period of B.C. coverage ended Nov. 30, so they were left without coverage for five days before B.C. relented and offered to reinstate their insurance.

A B.C. official told Lauzon over the phone they would have to "bend the rules" to cover them, a statement that made her uneasy, she said.

I just want that comfort of being able to call up a family doctor and make an appointment.-  Angelica Lauzon

When she tried MCP again, an official told Lauzon that Canadians are sometimes left without coverage due to clashing rules between provinces. The official said MCP had dealt with three similar cases in a week, two of them from Ontario.

Health Canada confirmed in a statement there are sometimes disputes between provinces that, in "rare" instances, lead to Canadians falling through the cracks. In those cases, the health authority would step in and mediate the disagreement, the agency said.

Although it didn't get to that point for Lauzon and Walker, the ordeal has left her anxious and frustrated — and "kind of paying double," she says, for medical services in B.C. while her taxes go to N.L.

"I'm speechless, really," Lauzon said. "I just want that comfort of being able to call up a family doctor and make an appointment."

'That's crazy,' says health minister

Minister of Health and Community Services John Haggie said he wasn't aware of Newfoundland and Labrador residents being denied health coverage and there had been no direction from his department to restrict eligibility.

"In actual fact, we've been looking at opening up eligibility requirements for people coming in from outside as part of our immigration and economic stimulus approach, so that we can encourage people to come here," Haggie said.

"If you've got a Canadian citizen who wants to move to Newfoundland and Labrador and can't get coverage, that's crazy. We're open for business."

Morton has no intention of moving back to B.C., but may need to have her gall bladder removed there. (Sherry Vivian/CBC)

Haggie encouraged anyone falling through the cracks to call his office.

The health department said it does not track rejected MCP applications.

Pressure to leave

Thanks to the "portability clause" in the Canada Health Act that allows Canadians to obtain insured services between provinces, an out-of-province health card should grant someone access to medically necessary health services in N.L.

But Morton, meanwhile, said that's not her experience; she knows first-hand the system doesn't work as smoothly as it's supposed to. Until her gallstones cause a medical emergency, she's left without any viable means of having them removed.

For Morton, the way MCP handles students seems outdated, a relic of a time when people moved to another province for school and returned home to family. And as long as it remains in place, she said, students might think twice about sticking around.

"By maintaining these sort of policies, we give people the impression they're expected to just be temporary," Morton said.

"I don't think it's unusual, or something we should be discouraging, that once people start school they decide to stay here.… Ultimately, if I have to look after myself, they're putting undue pressure on me to leave."

Read more from CBC Newfoundland and Labrador

ABOUT THE AUTHOR

Originally from Scarborough, Ont., Malone Mullin is a CBC News reporter in St. John's. She previously worked in Vancouver and Toronto. Reach her at [email protected].