Working Without a Safety Net

Ministry of Health and Long-term Care (OHIP)

Date: 2009

Working Without a Safety NetNine former foreign students who were living and working in Ontario under the federal Post-Graduation Work Permit Program complained to the Ombudsman about being refused health coverage under the Ontario Health Insurance Plan (OHIP).

The Post-Graduation Work Permit Program is operated by Citizenship and Immigration Canada (CIC) and issues work permits to foreign graduates from participating Canadian post-secondary institutions to allow them to stay and work in Canada after graduation. In April 2008, CIC removed the requirement for program participants to have a job offer from a Canadian employer before obtaining a work permit. Instead, they were issued “open” work permits that did not list any specific employer’s name or the participant’s occupation.

This change conflicted with OHIP’s eligibility regulations, which require a work permit that is valid for at least six months and specifically names an Ontario employer and the participant’s occupation. The complainants expressed concern that without OHIP coverage they would have to incur out-of-pocket costs to get health care – and that in the case of a medical emergency, they would not be able to afford treatment.

Officials at the province’s Ministry of Health and Long-Term Care initially told the Ombudsman’s Office that they had not been forewarned about the federal changes, although they would work to amend the OHIP requirements. However, Ombudsman staff determined that CIC had in fact held consultations with provincial stakeholders in 2006, which included an email to Ontario’s Ministry of Training, Colleges and Universities, asking for advice on any potential impact of the change to “open” work permits on access to provincial health care. The email was sent on to the Ontario Ministry of Citizenship and Immigration, and although both ministries discussed the CIC’s potential changes, the issue of “open” work permits and their effect on eligibility for OHIP was never addressed.

Senior officials at both provincial ministries expressed regret that the issue hadn’t been dealt with earlier. They assured the Ombudsman’s Office that they had taken steps to prevent this happening again, including introducing more formal processes to respond to requests from other levels of government. They also had recently entered into a Memorandum of Understanding with each other to improve and clarify the co-ordination of shared initiatives.

On April 1, 2009, the Ministry of Health and Long-Term Care amended the OHIP eligibility regulations to allow holders of the new “open” work permits to be eligible for coverage if they are employed and working in Ontario for no less than six months. The Ministry also agreed to speak individually with each of the nine complainants to explain the new regulation and inform them how to reinstate their OHIP coverage.