She's technically still a visitor. And no, marriage is not "good enough" and she is not eligible for MSP. They need to apply for permanent residency ASAP (preferably Outland since she's American). Once the application is in process, he can apply for MSP for her (see link below). She still has a wait period though so probably best to not do something silly like get pregnant on purpose.... (You'll notice that giving birth while not covered by healthcare is a very popular topic on the Health board.)
Ordinarily, the wait period for coverage for a spouse/child that is residing in B.C. and has later become an applicant for permanent resident status consists of the balance of the month Citizenship and Immigration Canada (CIC) accepts an application for permanent resident status, plus two months. In some circumstances, the wait period may begin on the date the application fee for permanent resident status was received by CIC if the spouse/child has been residing in B.C. since that time. This is provided there is no significant delay between the fee being paid and the application being received by CIC.
From the relevant article from MSP: http://www2.gov.bc.ca/gov/DownloadAsset?assetId=3BE8B2E4E1C34424815ABA87A1726944&filename=covering-a-spouse-or-child-who-is-an-applicant-for-permanent-resident-status-in-canada.pdf