Members of groups who sponsored two Syrian refugee families hold up signs as they wait for the families to arrive at Toronto's Pearson Airport in December, 2015.Chris Young/The Canadian Press
On June 18, 2012, doctors and other health care workers all across the country staged a walkout to protest the government’s changes to refugee health care benefits in Canada. Roughly two months earlier, the Stephen Harper government had announced that cuts were coming to the Interim Federal Health Program (IFHP), which provides temporary health care coverage for refugees in Canada.
The IFHP had covered both basic care and extended services, such as vision, dental, and prescription medication, but that was ending: as of June 30, that extended coverage would be eliminated (with the exception of immunizations or medications for diseases that pose a public health risk) for all refugee claimants, and refugee claimants from designated “safe” countries would see their coverage pared back almost entirely.
Doctors were livid. Health care providers staged protests outside of ministers’ offices and on Parliament Hill. One group launched a federal court challenge, which produced a decision that deemed the changes “cruel and unusual.” The Harper government appealed, but that appeal was dropped when the Trudeau Liberals took over in 2015. The following year, IFHP coverage was restored to pre-2012 levels.
As far as I am aware, there is no country-wide, multi-day protest scheduled now in response to the government’s plan to again scale back refugee health care coverage. This week, the Mark Carney government announced that as of May, asylum-seekers covered under the IFHP will be required to pay a flat fee for prescriptions – $4 each – and 30 per cent of the cost for extended services.
Some advocates are concerned, of course, noting that even seemingly nominal fees can add up for vulnerable persons, particularly those fleeing persecution from regions where they were denied proper health care. But the public’s response, so far, has been muted. Indeed, it might be a sign that based on Canada’s current economic and social climate, the time to rein in the IFHP is now.
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The problem plaguing the IFHP both in 2012 and in 2026 is the perception of unfairness: Canada’s public health care system does not include coverage for extended services and prescriptions for Canadian citizens and permanent residents, but it does for those eligible for the IFHP.
There are various arguments that justify that discrepancy, including the fact that refugees often arrive with complex medical needs after years of neglect, and it may be cheaper in the long run to treat them up front. There are various provincial programs that do cover the cost of prescriptions and extended services for low-income Canadians, but asylum-seekers will have more trouble navigating the complex bureaucracy, especially if there is a language barrier. IFHP keeps it simple.
These arguments were more persuasive in 2012, when the program was a fraction of its current size, and there wasn’t the widespread perception that Canada’s refugee system was being abused. In 2012, roughly 128,000 people were covered by the IFHP. In 2024-2025, that number exploded to 623,365, with expenses totalling nearly $900-million.
The Canadian government hasn’t said exactly how much it expects to save with its new co-payment model (the changes in 2012 were projected to save $100-million over five years), but considering the current cost of living pressures facing Canadians, and the economic uncertainty of our continuing trade negotiations with the U.S., it is fair for the government to make the case that it no longer constitutes a reasonable use of taxpayer dollars to pay for extended health coverage for more than 600,000 people who may or may not have their asylum claims approved.
The change also reduces, though doesn’t eliminate, an incentive for those facing deportation to claim asylum instead. It does place an added burden on refugees legitimately seeking asylum in Canada, but there are other programs – the Resettlement Assistance Program allowance – which could be modified to include a special allowance for those with a demonstrated need, akin to the existing special allowance for pregnancy.
There’s also a social imperative for bringing refugee benefits closer in line with those afforded to Canadian citizens. That’s because, bluntly, the Trudeau government destroyed the immigration consensus in Canada; it brought in so many newcomers, so quickly, that integration was impossible and resentment inevitable. The Carney government is now tightening the rules for student visas, work permits, and asylum claimants, but it will take a lot more than a change in numbers for Canadians to again believe that immigration is a good thing, and to trust that our processes are rigorous and fair.
Asking refugee-claimants to budget for prescriptions and extended coverage, as many other Canadians do, helps to ameliorate that wounded perception of fairness. Arguably the changes to the IFHP needs to go further, but this is a necessary first step.