CIMM – Interim Federal Health Program: Healthcare Coverage for Refugees and Asylum Seekers – March 3, 2022

Key Messages

• The Government of Canada has invested $738.9M over two years (2021-2022 to 2022-2023) in the Interim Federal Health Program (IFHP) to ensure that refugees and asylum claimants have access to temporary healthcare coverage to address their immediate and essential medical needs.
• The Program is an important component of the Government’s suite of federal benefits for newcomers, supporting their settlement outcomes and their ability to fully participate in their new communities.
• Through the IFHP, the Government bridges a gap in health coverage for refugees and asylum claimants until they qualify for provincial or territorial insurance, as well as for other uniquely vulnerable migrants who would otherwise not receive publicly funded healthcare in Canada.
• The IFHP also funds certain overseas pre-departure medical services for refugees under our resettlement programs, including vaccinations, to mitigate health risks prior to their arrival in Canada.

Supplementary Messages

Interim Federal Health Program funding

• Prior to the pandemic, the cost of the IFHP had been increasing year-over-year due, primarily, to new humanitarian commitments and unpredictable asylum volumes. 
• While Program expenditures have been lower than expected since March 2020 as a result of pandemic restrictions, the reopening of our borders is leading to growth in eligible populations and a concomitant growth in costs for the IFHP.
• Economic and Fiscal Snapshot 2020 provided funding for the IFHP in the amount of $327.7M for 2021-2022 and $411.2M for 2022-2023. Funding of $411.2M is being sought through the 2022-2023 Main Estimates, representing an increase of $83.5M over the previous fiscal year which reflects the increase in eligible clients.
• Given the effects of the pandemic on Canada’s healthcare system, investments in the Program continue to play an important role in minimizing the impact of newcomer health on provinces and territories; offsetting expenses, lowering long-term costs, and helping to ensure the sustainability of publicly-funded healthcare.

Interim Federal Health Program COVID-19 response

• The pandemic has made it more challenging for alike to access certain health-care services. In light of reduced in-person care, we have expanded IFHP coverage to include a range of tele and virtual services.
• This has helped to facilitate access to health services for refugees and asylum claimants and other vulnerable newcomers who may be disproportionally affected by the pandemic, and who may face barriers in attending health services due to their location, physical disability, or child care responsibilities.
• Overseas, the Department is working with the International Organization for Migration to deliver COVID-19 specific pre-departure medical services to resettled refugees before their arrival in Canada, including testing, isolation services, and vaccines where available.

Supports for foreign nationals from Afghanistan

• Afghan nationals seeking refuge in Canada may have been evacuated on an urgent basis, some with minimal resources, and with physical and mental health issues that may require immediate and ongoing medical attention.
• The IFHP is contributing to Canada’s response to the situation in Afghanistan. Afghan nationals under Canada’s special immigration measures and dedicated humanitarian and extended family-reunification programs are receiving in-Canada health benefits and pre-departure medical services, including coverage of their immigration medical exams.
• This coverage ensures that medical interventions are available prior to and during travel, that barriers to integrating into our healthcare system are minimized, and that their limited financial resources can be redirected to support their settlement in Canada.

If pressed - Policy on Discretionary Healthcare Coverage for Individuals (Responsive lines if asked about discretionary IFHP coverage)

• We recognize that there may be instances where a foreign national residing in Canada needs healthcare coverage but is not eligible under the IFHP.
• Upon request, an individual may be provided with healthcare coverage if they are in a refugee-like situation or in a situation where humanitarian considerations apply, and are facing both urgent medical and compelling personal circumstances.
• This coverage is provided on an exceptional, case-by-case basis. It is not meant to cover healthcare costs for uninsured foreign nationals in all situations.
• I have assigned decision-making authority to appropriate senior level officials to act on my behalf. This ensures that individuals needing urgent medical attention receive a timely response, which, in turn, can help expedite the delivery of essential health services.
• The Department has also put in place a policy to inform applicants of the intent of this discretionary coverage, as well as the criteria and factors guiding my officials in assessing their request.
• The policy ensures that the discretion is exercised in a fair, transparent, and consistent manner that is in line with the objectives of the IFHP.

Supporting Facts and Figures

Eligible Beneficiaries

• In fiscal year 2020-2021, 217,807 newcomers were eligible for the IFHP. This was 22% lower than in fiscal year 2019-2020, which saw the IFHP’s highest recorded number of clients at 280,322. This decrease is attributed to reduced refugee and asylum claimant intake in light of pandemic restrictions.

IFHP Eligible Beneficiaries by year

Source: IFHP Population Profile - PIU Statistics.

• The Department continues to work closely with a network of more than 94,000 service providers registered with the IFHP to ensure that newcomers are well-supported and can access medical care upon arrival in Canada.

Background

• Authority for the IFHP flows from the Crown’s prerogative to make ex gratia payments. The IFHP is not grounded in the Immigration and Refugee Protection Act (IRPA). The Minister has authority to administer the IFHP, as it falls within the Minister’s mandate on immigration matters.
• Through the IFHP, the Government addresses a gap in health coverage for certain vulnerable foreign nationals who do not have access to provincial or territorial health insurance or extended healthcare benefits, on an interim basis.
• Principally, the IFHP provides limited, temporary coverage of healthcare benefits to resettled refugees, asylum claimants (including failed asylum claimants), protected persons in Canada, victims of human trafficking, and foreign nationals detained pursuant to the authorities in IRPA.
• The objective of the IFHP is to improve health outcomes for vulnerable or disadvantaged migrants identified in the eligible groups by facilitating access to the healthcare system and removing disincentives to seeking care, allowing them to address any immediate and ongoing medical needs. In doing so, the IFHP supports the Department’s broader mandate of enabling longer-term integration, inclusion and full participation of migrants in Canadian society.
• While duration of coverage varies depending on immigration category, all beneficiaries in Canada receive full medical coverage, which includes basic benefits similar to provincial or territorial health insurance (e.g. hospital, physician, and laboratory services), supplemental benefits (e.g. dental and vision care, assistive devices, mental health counselling) and prescription drug benefits, similar to what provinces and territories provide to social assistance recipients.
• Asylum claimants receive basic, supplemental and prescription drug coverage for the full duration of the refugee determination process, from the point of making their claim to an officer in Canada until they become eligible for provincial or territorial health insurance or, in the case of unsuccessful claimants, leave Canada.
• Resettled refugees receive coverage of basic benefits until they transition onto their provincial or territorial health insurance plan (typically up to three months). They also receive supplemental and prescription drug coverage while they are receiving income support through the Resettlement Assistance Program (or its equivalent in Quebec) or while they are under private sponsorship (typically 12 months). After this time, refugees may transition to provincially-funded extended health benefits.
• Resettled refugees also receive coverage of certain pre-departure medical services prior to their arrival in Canada. This includes the cost of their immigration medical examinations, certain voluntary vaccinations in alignment with those recommended in Canada, medical support required during travel (e.g. medical attendants), and services to manage communicable disease outbreaks. These measures are helping to facilitate safe and timely resettlement in Canada.
• The IFHP is administered by a contracted third-party claims administrator (currently Medavie Blue Cross), which registers health-care providers under the Program, processes invoices, reimburses providers for eligible services rendered, and provides a routine audit function to identify and control improper claims.
• Economic and Fiscal Snapshot 2020 provided funding for the IFHP in the amount of $327.7M for 2021-2022 and $411.2M for 2022-2023. The Treasury Board Submission was approved by the Board on December 10, 2020 and $327.7M in funding was sought through the 2021-2022 Main Estimates. For the 2022-2023 Main Estimates, $411.2M is being sought, an increase of $83.5M over the previous fiscal year.