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The federal government is asking Parliament to approve hundreds of millions of dollars in new spending to cover the health care costs of eligible refugees and asylum seekers — a budget item that has ballooned in recent years as the number of these newcomers reached record highs.
The Interim Federal Health Program (IFHP) is intended for immigrants who are not yet eligible for provincial or territorial health care. By removing some barriers to health care, the program makes it easier for refugees – many of whom are fleeing conflict or persecution abroad – to get the care they need upon arrival.
There is also a public health benefit: it helps prevent and control the spread of infectious diseases in Canada.
Some resettled refugees receive only a few months of health care through the IFHP before transitioning to provincial plans. Some are staying with the federal plan much longer as they wait for their claims to be adjudicated — a process that now drags on over two years while Ottawa struggles with a growing backlog.
The cost of the IFHP has risen from about $60 million in 2016 to a projected $411.2 million this year, easily exceeding inflation.
The number of asylum applications around the world is growing, but an increasing share of them are now being submitted in Canada. Andrew Chang explains how Canada became the fifth largest recipient of asylum seekers, and the public policy decisions that analysts say contributed to it.
Former Prime Minister Stephen Harper's Conservative government curtailed the IFHP and completely eliminated coverage for some refugees and asylum seekers as part of an effort to reduce spending and balance the budget.
The Harper government also said it was unfair for taxpayers to have to pay for a program that in some cases was far more generous than what is available through public health care to some Canadian citizens and permanent residents.
The decision to end the program sparked a wave of criticism and was ultimately deemed unconstitutional by a Federal Court judge.
In 2016, the Liberals reinstated the program — which includes primary care, hospital visits, laboratory tests, ambulance services, vision and dental care, home and long-term care, psychologists, counseling, devices such as hearing aids and oxygen machines, and prescriptions. medications, among others.
A review of the data by CBC News shows how much more the program is costing after years of global unrest and the resulting influx of people fleeing to Canada.
A sevenfold increase in healthcare costs for refugees
When the Liberals announced the program's restoration, the then-immigration minister said the program would cost about $60 million a year.
The costs quickly doubled to $125.1 million per year in 2019-2020 and more than doubled again after that $327.7 million in 2021-2022government data shows.
In the government's supplementary estimates tabled this week – part of the legislative process to ask Parliament for more money to cover initiatives not yet funded – Ottawa is now asking for $411.2 million per year for IFHP.
Donald Trump's pledge to crack down on illegal immigration in the US is raising concerns about an influx of migrants entering Canada. Officials say the country simply cannot accommodate them, while advocates fear migrants will risk their lives in frigid conditions.
A spokesperson for Immigration, Refugees and Citizenship Canada (IRCC) said the new funding for IFHP is intended to “cover costs associated with health care benefits for eligible beneficiaries as Canada continues to respond to increased numbers of asylum applications.”
“These funds will enable continued implementation of the IFHP while offsetting costs to provinces and territories, and support the government's commitment to facilitating care for some of Canada's most vulnerable populations.”
A spokesperson for Immigration Minister Marc Miller did not respond to a question about reducing the number of asylum seekers to reduce associated health care costs.
The IFHP boost is just one of the budget requests in this year's supplemental estimates. In total, the government is looking to raise approximately $1 billion more for Immigration, Refugees and Citizenship in Canada this fiscal year.
Record number of asylum seekers and refugees
When the health program was fully reinstated in 2016, some 130,340 refugees and asylum seekers were eligible for coverage, according to figures. government statistics.
That figure doubled to 280,322 in 2019-20, as the federal government accepted many more newcomers — many of them from locations like Roxham Road in Quebec, where thousands of people have crossed into Canada “irregularly.”
When then-President Donald Trump restricted immigration and increased deportations, many more people decided to move north to avoid Trump's dragnet. Canada too relaxed visa requirements for visitorsleading to more asylum applications at airports.
While Canada and the US have since moved to close Roxham Road and abolish “irregular border crossings,” and Ottawa has tightened visa restrictions again, the flow of people seeking asylum and refuge in this country has not slowed.
In the first nine months of 2024 alone 132,525 people have applied for asylum – almost as much as in the whole of 2023, which was already a record year.
About 53,000 refugee claims have also been filed from September 2024 – a figure that exceeds all claims filed last year.
A spike in the number of new asylum and refugee applicants, combined with those already here, means the IFHP is on track to cover more people and their healthcare costs than ever before.
In a statement to CBC News, Conservative Party immigration critic Tom Kmiec said Prime Minister Justin Trudeau and “his incompetent ministers have broken our immigration system and allowed fraud, chaos and disorder to run rampant.”
“He encouraged irregular border crossings and invited asylum seekers to come to Canada. They did nothing about Roxham Road for over six years and relaxed visa requirements for visitors, resulting in a sharp increase in asylum applications at our airports. Now Canadians are paying the price for the chaos he created,” Kmiec said.
The Conservatives have said they will reduce the number of new immigrants if elected by linking the number of arrivals to the start of housing. Kmiec did not say what the Conservatives' policy on asylum seekers and refugees would be if they formed the next government.
An asylum seeker – also called an asylum seeker or refugee applicant – comes to Canada to seek refuge and asks the government to consider him a refugee. These claimants typically spend months or years at the IFHP waiting for Ottawa to review their files.
However, resettled refugees fall into a different category because they are referred to Canada by the UN High Commissioner for Refugees, another designated referral agency, or a private sponsor group. They are screened abroad before being issued a visa to come to Canada.
These refugees typically transition to provincial health care plans relatively quickly because they are considered permanent residents upon arrival — but they retain certain additional benefits, such as pharmaceutical care, longer than other immigrants.
Previous cuts to refugee health care were 'disastrous': expert
YY Chen is an associate professor at the University of Ottawa School of Law and an expert on the intersection of international migration and health.
Chen said the IFHP serves two purposes: one humanitarian, the other fiscal.
The program provides care to people who are often fleeing traumatic circumstances and have unique physical and mental health needs.
It's also more cost-efficient to address health problems right away rather than letting them fester, Chen said.
“These refugees will become members of our society in the long term. It is to help them resettle in this society and integrate them so they can start on the right track,” Chen said in an interview with CBC News.
“We also don't want to leave any gaps when it comes to the prevention and control of infectious diseases,” he added. “It could undermine the health of society as a whole.”
Past conservative cuts have been “detrimental” and had a “disastrous effect on the health of refugees and asylum seekers,” Chen said, adding that curbing these benefits in the future would be deeply disruptive.
But Chen said the historic recent surge in new migrants is putting “a lot of pressure” on a health care system already struggling with a shortage of primary care physicians and long wait times.
“Adding more people to the system will make it even thinner. That's a concern,” he said.
