Ontario won't reverse decision to end funding for uninsured health care

Ontario’s minister of health says the province will not reverse the decision to end funded health care services to the uninsured.

Speaking in the legislature on Monday morning, Sylvia Jones insisted that changes being made as of March 31 will not affect the health of those without coverage under the Ontario Health Insurance Plan (OHIP). Instead, Jones said, they will affect whether health-care facilities can bill for service provided to those patients.

“There's no change in the way that uninsured persons will receive care in the province of Ontario,” she said.

"The only change is how hospitals, community health and midwifery centres will be reimbursed for insuring and providing that care."

A memo sent to Ontario hospitals and health providers by the Doug Ford government late last week said the province's existing framework and funding for treating uninsured patients, initiated in March 2020, would come to an end in April.

The program allowed anyone to access “medically necessary physician and hospital services” with or without a health card.

As of April 1, hospitals and physicians will no longer be able to bill the province for treating the uninsured.

“What it means is that if you don't have a health card, you're much less likely to get preventive and primary care because you're not going have an ongoing relationship with a primary care practitioner,” Toronto ICU Dr. Michael Warner told CTV News Toronto on Saturday.

“Those on the margins are the ones who are going to be harmed the most in addition to the physicians who treat those marginalized groups, they're just going to be working for free, and that's not fair either.”

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Uninsured patients can include, but are not limited to, individuals who cannot get a health card for various reasons, as well as migrant workers between contracts, or those without residency status. Homeless residents often experience added challenges getting a health card due to a lack of identification and permanent address.

These individuals can still access care at 75 community health centres across Ontario as well as in hospitals via the emergency department, the government said. A list of those health centres can be found on the government's website.

PROGRAM WAS NOT ABOUT ADDRESSING EQUITY

In defending the cessation of the program, the ministry reiterated that it was launched during provincial lockdowns. This, the minister stressed Monday, prevented people from leaving Ontario to go somewhere else where they could receive care.

“The program was put in place when individuals could not travel in the province of Ontario,” Jones said.

“Because of that order, we put in a funding model that ensured that individuals who were in Ontario could get the medical coverage they needed.”

While this may have been the case, experts say it also benefited others who experience barriers to getting a health card, regardless of whether they were eligible. Physicians and advocates praised the move as solving a significant equity issue when it comes to accessing health care in Ontario.

“When the funding became available in 2020, it was a game changer,” Dr. Andrew Boozary with the University Health Network, told CTV News Toronto.

“Removing that stigma and barrier for people to access care was a crucial part [of] what we were trying to do to improve health in marginalized communities,” he said.

Speaking with CTV News Toronto on Monday, Warner added that hospitals are using the program at a higher rate now than in the first year. He also noted that travel restrictions have been gone for a long time, meaning that individuals stuck in the province as a result of lockdowns weren’t the demographic truly benefiting most from the funding.

“Have we learned nothing from the pandemic?” Warner asked. “There were things the government did that were actually very good decisions that helped people and instead of discarding them on March 31, because in their view the pandemic is over, we should actually evaluate the program, see how effective it was, and improve upon it instead of canceling it.”

An open letter signed by more than 1,100 health-care workers and community and advocacy groups also asks the province to reverse its decision and permanently fund care for uninsured patients.

“The government made the correct decision to ensure that any person living in Ontario can receive essential care,” the letter said, adding that prior to March 2020 about half a million people didn’t have public health insurance.

“To deny care to anyone, leaving them at risk of severe illness or death, is unacceptable.”

A related online petition launched Monday, just days after the government announced the program's end, has nearly 400 signatures.