Individuals seeking refugee protection in Canada often do so to escape perilous conditions in their countries of origin, including persecution, war, or violence, and typically arrive with limited financial resources, support networks, and significant mental and physical trauma.
In this context, the Canadian Immigration Lawyers Association (“CILA”) highlights the impacts arising from changes implemented by Immigration, Refugees and Citizenship Canada (“IRCC”) to the Interim Federal Health Program (“IFHP”). CILA is concerned that these changes risk undermining access to essential health care for already vulnerable populations and will result in significant individual and system-wide consequences, without addressing the underlying systemic challenges within the refugee protection system.
Overview of the IFHP and Recent Changes
At present, the IFHP provides temporary and limited health coverage to refugee claimants, protected persons, resettled refugees, and other eligible groups until they qualify for provincial or territorial insurance. The program supports a large and growing number of individuals, with costs driven by increased asylum claims and prolonged processing times. Despite this reliance, IRCC has announced that, effective May 1, co-payments will be introduced, including a $4 fee per prescription and a 30% cost share for certain supplemental services such as dental, vision, counselling, and assistive devices, payable at the point of care. While essential services like physician and hospital care will remain fully covered, these changes will nonetheless impose financial barriers to necessary health care for individuals who are already economically vulnerable and at heightened risk of adverse health outcomes. The reach and reliance of the program therefore make any reduction in coverage a matter of significant concern for some of Canada’s most vulnerable residents.
Impacts on Vulnerable Populations: Children and Mental Health
These impacts are particularly acute for children and for refugee claimants experiencing mental health challenges. Refugee children often arrive in Canada having experienced violence, conflict, displacement, or disrupted health care, leaving many with untreated or ongoing conditions at a critical stage of development. Timely access to services such as dental care, vision care, and therapy is therefore not discretionary but essential to their functional capacity and long-term well-being. These challenges are not limited to children, as many adult refugee claimants also carry significant mental health burdens, including anxiety, depression, and post-traumatic stress disorder resulting from trauma before, during, and after migration. Access to care is already limited by language barriers, stigma, and a lack of culturally appropriate services, and the introduction of co-payments creates additional financial barriers that may cause manageable conditions to deteriorate, increasing reliance on emergency and crisis services and shifting costs to more resource-intensive areas of the health care system.
Systemic Challenges and Recommendations for a Fairer Refugee System
These changes must also be understood in the context of significant delays in refugee processing, with claims taking roughly 22 months from referral to decision and a backlog exceeding 296,000 claims, leaving many individuals in prolonged uncertainty. During this period, the IFHP is often the only health coverage available to claimants, making cuts to the program particularly consequential. While CILA recognizes the federal government’s efforts to manage increasing pressures on Canada’s asylum system, balancing budgets on the backs of refugee claimants is not sound public policy. A more effective approach would focus on improving efficiency and procedural fairness, including expanding paper-based decisions, prioritizing straightforward cases, and implementing targeted measures to reduce the backlog. CILA calls on the federal government to reverse the IFHP cuts and pursue reforms that strengthen the fairness and sustainability of Canada’s refugee protection system, while ensuring equitable access to essential health care.
