By Mata Press Service

The federal government’s decision to require refugees and asylum seekers to pay a share of their health-care costs is drawing sharp criticism from unions, migrant advocates and front-line doctors, who say the move will deepen hardship for some of the country’s most vulnerable residents.

In its first budget, the Mark Carney government announced changes to the Interim Federal Health Program that will take effect May 1. Resettled refugees and refugee claimants will be required to pay 30 per cent of supplemental health costs, including dental, vision and mental-health services, along with a $4 co-payment for each prescription drug.

Ottawa says the changes are aimed at reducing payments to private insurer Medavie Blue Cross, which administers the program. The government projects savings of $358 million over the next two years.

But critics argue the savings will come at a steep human and financial cost.

The Interim Federal Health Program was created in 1957 to provide temporary health coverage to refugees and asylum claimants who are not eligible for provincial or territorial health insurance. Claimants can wait months or years for their cases to be decided and, during that time, have no access to provincial health plans or social assistance. Even approved refugees can face waiting periods before they qualify for provincial coverage.

The program currently provides coverage comparable to provincial plans, including basic medical services and certain supplemental supports.

Under the new rules, refugees will pay a portion of supplemental costs and prescription fees out of pocket.

The Canadian Union of Public Employees said the government is “offloading health-care costs to vulnerable refugees” rather than addressing administrative backlogs that have driven up program expenses.

Program costs have risen sharply in recent years. A report from the Parliamentary Budget Officer found that annual spending grew from $226 million in 2021 to $896 million in 2025, largely due to an increase in asylum claims. Without changes, costs could reach $1.5 billion by 2030.

Conservative Leader Pierre Poilievre has seized on those figures, calling for a full review of the program and urging the federal government to limit coverage to “emergency life-saving health care” for rejected claimants. In social media posts, he referred to “deluxe benefits” for “fake refugees.”

A Conservative motion to curb the program was defeated in the House of Commons last week, with Liberal, Bloc Québécois and NDP MPs voting against it.

Liberal MP Yasir Naqvi accused the Conservatives of inflaming public opinion rather than offering workable reforms.

“This has nothing to do with facts,” Naqvi told the House. “It completely has to do with dividing Canadians.”

Even so, health-care providers say the government’s own co-payment plan risks repeating mistakes from the past.

Dr. Meb Rashid, director of the Crossroads Clinic in Toronto, said a 30 per cent co-payment on counselling services effectively shuts the door on care for people who have fled war, torture or persecution.

“For many of our patients, that means those services simply won’t be accessed,” he said in an earlier interview about the proposed changes.

Advocacy groups note that $4 per prescription can quickly add up. A refugee managing diabetes and hypertension may require five or six medications a month. That could mean $20 to $24 in monthly drug fees, in addition to dental, vision or trauma counselling costs.

Many asylum seekers arrive with limited savings and face barriers to employment, including language challenges and delays in obtaining work permits. They also shoulder legal fees, application costs and other expenses linked to their immigration status.

Migrant Rights Network, a national advocacy coalition, has launched a campaign urging the government to reverse the cuts before they take effect.

“People will skip medications. They will avoid the dentist. They will forgo counselling,” the group said in a statement. “They will get sicker and end up in emergency rooms that cost the system far more than prevention would have.”

The debate echoes a similar confrontation in 2012, when Stephen Harper’s Conservative government reduced IFHP coverage. Doctors staged walkouts and several provinces stepped in to fill gaps. In 2014, the Federal Court ruled that the changes amounted to “cruel and unusual treatment” in violation of the Charter of Rights and Freedoms.

Justice Anne Mactavish wrote that the cuts jeopardized “the health, the safety and indeed the very lives” of vulnerable children and adults. The ruling was later upheld, and the program was restored after the Liberals formed government in 2015.

Critics of the current reforms say the underlying cost pressures stem less from the scope of benefits and more from processing delays.

Asylum backlogs have grown significantly in recent years. Claimants often remain in the federal program for extended periods while waiting for decisions. The union representing federal workers argues that cutting staff who process refugee claims will prolong those waits and increase overall costs.

“Instead of clearing the backlog, the government is shifting the bill to people who have the least ability to pay,” CUPE said.

Supporters of reform counter that the program must be sustainable and aligned with broader pressures on Canada’s health-care system. Conservative immigration critic Michelle Rempel Garner has argued that public support for immigration has declined and that taxpayers expect greater accountability.

An Environics poll last fall found that a plurality of Canadians agreed with the statement that too many refugees are not genuine claimants.

Immigration policy experts caution that rhetoric can obscure the legal realities. Some rejected claimants succeed on appeal and later become permanent residents or citizens. Limiting health care during that period could have long-term consequences for integration and public health.

The Carney government is also advancing Bill C-12, legislation that would tighten asylum rules, including a requirement that claims be made within one year of arrival in Canada. Advocacy groups say the bill, combined with health-care cost-sharing, signals a broader shift in refugee policy.