What is OHIP?

OHIP stands for the Ontario Health Insurance Plan. It is the publicly-funded health insurance plan that covers medically necessary health services laid out in the Canada Health Act, as well as other health services determined by the province. Individuals need to provide an OHIP card whenever they seek care in order to prove their eligibility and to receive coverage for their care.

Who does not have OHIP?

Approximately 500,000 people or more in Ontario currently lack OHIP coverage. There are five main groups of individuals who are not able to access OHIP coverage:

1. Individuals in the 3 month waiting period.

Newly arrived landed immigrants, temporary foreign workers and returning Canadians are denied OHIP coverage until three months after their date of arrival in Ontario. (see “What is the 3-month wait?” for more information) This runs counter to our practice of providing OHIP coverage and Interim Federal Health Program coverage on arrival to government-assisted refugees and privately-sponsored refugees.

2. Migrants with temporary status

Temporary status migrants often move between types of immigration status, during which period they often find themselves without OHIP coverage. This includes temporary foreign workers between contracts, and international students attending institutions that do not provide coverage, or moving from a student to a work visa. On top of this, temporary workers who do have OHIP coverage, often have other barriers to accessing care (employers holding on to OHIP cards, fear of losing their contract and being deported etc).

3. People with pending claims

Those who are pending results of an inland immigration sponsorship or humanitarian and compassionate application are not provided with status, and therefore lack access to OHIP coverage in the interim. This runs counter to the system in place for refugee claimants who are provided coverage through the Interim Federal Health Program.

4. People without status

There are many people living in our communities who are non-status (lack immigration status). They may have arrived in various different situations and often are living and working in precarious conditions. These individuals are not eligible for OHIP coverage and fear accessing health services due to threat of detention or deportation.

5. People who are unable to prove their eligibility for OHIP

Individuals who are eligible for OHIP but have lost their identification documents (e.g. passport, birth certificate) are not able to apply for an OHIP card and have access to OHIP funded healthcare. Many of these individuals are homeless and have no safe place to keep identification or live with a mental health condition. Children born to undocumented immigrants are Canadian citizens and eligible for OHIP, but often find barriers in proving their eligibility and in accessing OHIP coverage.

What is the 3 month wait?

New immigrants to Ontario, temporary foreign workers*, and Canadian citizens who have been out of the country for more than 212 days in the previous year currently have to wait three months before they can access OHIP. In reality, however, this wait can often be much longer. These individuals must pay out-of-pocket or purchase private health insurance in order to receive health coverage in the interim. Even individuals who can afford to buy private health insurance rarely afford . Only three provinces currently have this policy in place: Ontario, British Columbia, and Quebec.

The 3 month wait was originally implemented as a cost-saving measure in 1994 by the Ontario government. However, there has been no evidence that making individuals wait 3 months for care actually saves any money. On the contrary, individuals tend to delay seeking care until they receive coverage, which increases health care costs. As a result, many organizations such as the Ontario Medical Association and Access Alliance have called for the end to the 3 month wait.

*except workers in the Seasonal Agricultural Workers’ Program

What does OHIP for All mean?

There are countless cases of people being denied life-saving treatment, being asked for thousands of dollars in cash in return for care, receiving crippling bills, and experiencing negative health outcomes including several deaths as a result. “OHIP for All” reflects our belief that healthcare is a fundamental human right and that all Ontarians, regardless of immigration status, should be eligible to receive OHIP and have access to health care in Ontario.

What is OHIP for All asking for?

We are calling on the government of Ontario to provide truly universal healthcare to all Ontarians regardless of immigration status. This includes:

Ending the 3 month waiting period that prevents new immigrants, temporary foreign workers, and returning Canadians from accessing OHIP.
Providing OHIP coverage to those with temporary residency status, such as temporary foreign workers between contracts, and international students not otherwise insured.
Providing OHIP coverage for those with pending inland immigration sponsorship, and humanitarian and compassionate applications.
Providing OHIP coverage for all everyone else without status living in Ontario

Why is having OHIP important?

Ontarians who are uninsured often delay seeking medical care until they become very ill. They present to emergency rooms sicker than people with OHIP and also have more negative outcomes. When they do seek care, hospitals demand payment upfront and many individuals, being unable to pay, are turned away. Others end up with substantial debt. We encourage you to take some time to read a few stories of individuals who have had their lives and their health severely harmed by not having OHIP.

Rousseau et al. Journal of Immigrants and Minority Health (2013) Uninsured immigrant and refugee children presenting to Canadian paediatric emergency departments: Disparities in help-seeking and service delivery. doi: 10.1093/pch/18.9.465

Hynie et al.  Paediatric Child Health 18(9):465-469. (2016) Emergency Room Visits by Uninsured Child and Adult Residents in Ontario, Canada: What Diagnoses, Severity and Visit Disposition Reveal About the Impact of Being Uninsured. J Immigrant Minority Health. doi: 10.1007/s10903-016-0351-0

Why should everyone in Ontario have OHIP?

Healthcare is a fundamental human right. As a signatory of the United Nations’ Universal Declaration of Human Rights, we are responsible to guarantee accessible healthcare for all of our residents. Yet thousands of Ontarians suffer preventable health challenges, facing unmanageable bills and being denied care, at times leading to death.

Addressing health concerns early also means we prevent unnecessary complications that harm people’s health and also put unnecessary strain on our healthcare system. A study at a health centre that serves a large uninsured population in the United States showed that providing primary care to the uninsured actually reduces healthcare costs by reducing the total number of days spent in hospital. It is much more affordable and desirable to treat high blood pressure than a preventable stroke.

Kaufman, A., et. al. (2000). Managed care for uninsured patients at an academic health center: a case study. Academic Medicine, 75(4), 323-330. doi:
 10.1097/00001888-200004000-00007

Do other countries provide healthcare to people in similar situations?

More than twenty countries in Europe provide emergency care services free of charge for everyone regardless of status. This includes Austria, Bulgaria, Cyprus, Czech Republic, Denmark, Greece, Estonia, Finland, Hungary, Latvia, Lithuania, Poland, and Romania. Four European countries, Portugal, Spain, France and the Netherlands provide much more access to health care to those who are non-status under specified conditions (see citation for details).

In particular, France covers all health care for non-status migrants who have lived in the country for at least 3 months and have a household income below a set threshold. Around 45% of non-status migrants in France receive this coverage. Spain provides universal health coverage for all residents regardless of status if they register as residents of a municipality. Non-status migrants that don’t register still continue to have access to emergency care free of charge.

Gray, B. H., & van Ginneken, E. (2012). Health care for undocumented migrants: European approaches. Issues in International Health Policy (The Commonwealth Fund), 33, 1-12. Link out