On May 1, changes to a federal health program will mean refugees, asylum claimants and other marginalized groups must pay for health services that were previously covered by the government.
It’s a bad plan.
The Interim Federal Health Program’s (IFHP) new rules require beneficiaries to pay $4 for each eligible prescription and 30 per cent for every other supplemental health product and service, including dental care, vision care, mental health services, rehabilitation and essential medical supplies.
These co-payments are a major barrier to care for people already facing severe financial strain. The IFHP exists to provide temporary coverage for newcomers to Canada who aren’t yet eligible for provincial or territorial health coverage.
As doctors, we have a duty to provide care based on need and not someone’s ability to pay. It’s a core medical and Canadian ethic.
As Meb Rashid, medical director at The Crossroads Clinic in Toronto, recently told the Toronto Star, a $4 charge adds up quickly for patients managing multiple medications. “When refugees arrive, you want to settle their health down so they can enter the workforce, be productive and thrive. This will be an ill-advised impediment to that.”
Introducing fees for a population already facing systemic barriers will deter early care and erode trust in the health care system. However, these new rules won’t just hurt the most marginalized among us – they will also put more pressure on a health care system already stretched to its limits.
When patients can’t afford prescriptions to treat chronic diseases or they forgo urgent dental treatment, their health conditions worsen and can lead to more complex problems. When they delay seeking care, there’s only one place to go: the emergency department, which happens to be the most expensive setting for health-care delivery.
When preventative care is discouraged, the costs shift downstream – patients may need costly diagnostics, hospital admission and specialist consults. In 2024-25, there were more than 16.1 million unscheduled emergency department visits reported in Canada compared to 15.5 million the year before, according to the most recent data from the Canadian Institute of Health Information. We should be reducing emergency department visits, not creating policies that drive people toward them.
The Canadian Medical Association (CMA) has been advocating for ways to strengthen Canada’s primary care system and to ease strain on hospitals and emergency departments. Barriers introduced by the IFHP would be a step backward.
In fact, we have been here before.
In 2012, the federal government implemented sweeping cuts to the IFHP, including coverage for essential medication, primary health care, prenatal care, child health check-ups, dental care, vision care, ambulance services and mobility devices such as wheelchairs.
Doctors, health-care organizations including the CMA and other advocates spoke out against the changes with rallies, open letters and a legal challenge. At the time, we warned the government of the dire consequences to individuals, families and the broader health-care system. Ultimately, the Federal Court of Canada ruled against the cuts, saying they resulted in “cruel and unusual treatment” for claimants. The resulting reversal of the policy showed the power of collective action.
We need to make ourselves heard once again. At the CMA, we are asking people to send a letter to the Minister of Immigration, Refugees and Citizenship to add their voice to this important cause. If a sustainable health-care system is the goal, these fees aren’t the answer.
The federal government needs to cancel the IFHP changes and instead focus on urgent solutions to our most pressing health care needs. It’s imperative we protect access to health care for refugees and asylum claimants. There is no compromise when it comes to equitable health care.
