Journal of International Migration and Integration

, Volume 16, Issue 4, pp 1041–1055 | Cite as

Harming Refugee and Canadian Health: the Negative Consequences of Recent Reforms to Canada’s Interim Federal Health Program

  • Helen P. Harris
  • Daniyal ZuberiEmail author


Recent legislative reform has drastically altered the ways in which asylum seekers are processed and treated within the Canadian immigration system. The Protecting Canada’s Immigration System Act, the provisions of which were staggered into effect over 2012, has created a two-tiered system whereby individuals are subject to vastly differential treatment based on their country of origin, status of refugee claim, and mode of arrival to Canada. Beyond introducing an extremely restrictive determination process, the federal Conservative government has also implemented a sweeping overhaul of the Interim Federal Health Program which has transformed health insurance coverage for asylum seekers into a limited and hierarchal system. This paper explores these draconian policy changes, outlines the problematic rhetoric and discourse that has fueled them, and details the subsequent level of organized opposition from the Canadian medical profession. It also provides a comprehensive analysis of predicted social and economic consequences that the reform will have on refugee claimants and on Canadian society as a whole. Finally, it outlines provincial reactions, with a particular focus on Ontario, and concludes with policy recommendations for the federal government and the province of Ontario.


Refugee policy Immigration Health care coverage Health care reform Canada 


  1. Barnes, S. (2012). The real cost of cutting refugee health benefits: a health equity impact assessment. The Wellesley Institute. Retrieved from
  2. Benner, A. (2013 January 27). Hard work ahead. Welland Tribune. Retrieved from
  3. Benzie, R. & Brennan, R. J. (2013 March 14). Ontario election still looms despite talks between premier Kathleen Wynne and rivals. The Toronto Star. Retrieved from
  4. Blizzard, C. (2013 January 30). Kathleen Wynne has some tough decisions ahead. Toronto Sun. Retrieved from
  5. Canadian Association of Community Health Centres (2012). Canada’s health centres call on federal government to reverse dangerous healthcare cuts. Canadian Association of Community Health Centres. Retrieved from
  6. Canadian Association of Optometrists, Canadian Association of Social Workers, Canadian Dental Association, Canadian Medical Association, Canadian Nurses Association, the Canadian Pharmacist Association, College of Family Physicians of Canada, & College of Physicians and Surgeons of Canada (2012 May 18). Letter to Minister Jason Kenney. Retrieved from
  7. Canadian Association of Refugee Lawyers & Canadian Doctors for Refugee Care (2013 February 25). Press release: doctors and lawyers challenge federal health cuts to refugees. Canadian Association of Refugee Lawyers. Retrieved from
  8. Canadian Council for Refugees (2009). Responding to chain email with false information. Canadian Council for Refugees. Retrieved from
  9. Canadian Council for Refugees (2012). Changes to healthcare for refugee claimants and protected persons inhumane. Canadian Council for Refugees. Retrieved from
  10. Canadian Council for Refugees (2013).Refugee healthcare: impacts of recent cuts. Canadian Council for Refugees. Retrieved from
  11. Canadian Doctors for refugee Care (2013). Canadian Doctors for Refugee Care. Retrieved from
  12. Canadian Healthcare Association (2012). Changes to the Interim Federal Health Program: position statement. Canadian Healthcare Association. Retrieved from
  13. Caulford, P., & D’Andrade, J. (2012). Health care for Canada’s medically uninsured immigrants and refugees. Canadian Family Physician, 58, 725–727.Google Scholar
  14. City of Toronto (2012). Health impacts of reduced federal health services for refugees. City of Toronto. Retrieved from
  15. Citizenship and Immigration Canada (2012a). Backgrounder overview: ending the abuse of Canada’s immigration system by human smugglers. Government of Canada. Retrieved from
  16. Citizenship and Immigration Canada (2012b). Interim federal health program: summary of benefits. Government of Canada. Retrieved from
  17. Citizenship and Immigration Canada (2012c). Making Canada’s asylum system faster and fairer. Citizenship and Immigration Canada. Retrieved from
  18. Citizenship and Immigration Canada (2012d). News release: reform of the Interim Federal Health Program ensures fairness, protects public health and safety. Citizenship and Immigration Canada. Retrieved from
  19. Citizenship and Immigration Canada (2013a). Backgrounder—summary of changes to Canada’s asylum system. Government of Canada. Retrieved from
  20. Citizenship and Immigration Canada (2013b). Health care—refugees. Government of Canada. Retrieved from
  21. Criscone, P. (2013 January 28). Docs want Ontario to fill gap in refugee health. Brampton Guardian. Retrieved from
  22. CUPE (2012 June 18). Refugee healthcare an investment, not charity. CUPE. Retrieved from
  23. Denton, T. (2012 May 17). They aren’t all ‘bogus’ refugees as portrayed by Kenney. The Winnipeg Free Press. Retrieved from
  24. Eggertson, L. (2013 March 11). Doctors promise protests along with court challenge to refugee health cuts. Canadian Medical Association. Retrieved from
  25. Graham, J. R., Swift, K. J., & Delaney, R. (2012). Canadian social policy: an introduction (4th ed.). Toronto: Pearson.Google Scholar
  26. Government of Canada (2012). Order respecting the Interim Federal Health Program, 2012. Government of Canada. Retrieved from
  27. Haber, R. (2010. Health Equity Impact Assessment: a primer. The Wellesley Institute. Retrieved from
  28. Health for All (2013 January 23). Health workers and concerned community members take on the Ministry of Health. Health for All. Retrieved from
  29. Immigration Matters in Canada Coalition (2012 June 14). Federal cuts put refugee health care in danger. Canadian Centre for Policy Alternatives. Retrieved from
  30. Jackson, S. (2012). The new interim federal health care program: how reduced coverage adversely affects refugee claimant’s employment. Ryerson Centre for Immigration and Settlement Brief No. 2012/1, 110. Retrieved from
  31. Jones, A. (2013 February 25). Doctor’s group takes Ottawa to court over refugee health-care cuts. The Globe and Mail. Retrieved from
  32. Karstens-Smith, G. (2012 May 7). Cuts to refugee health insurance dangerous, inhuman, doctors say. National Post. Retrieved from
  33. Kenney, J. (2012 May 11). Response to Ottawa Citizen re: IFH. Jason Kenney. Retrieved from
  34. Keung, N. (2012 May 11). Physicians occupied MP’s office over cuts to refugee health care. The Toronto Star. Retrieved from
  35. Matthews, D. (2012a June 27). Letter to Ministers Jason Kenney and Leona Aglukkaq. Retrieved from
  36. Matthews, D. (2012b December 14). Letter to Minister Jason Kenney. Retrieved from
  37. Ontario Government (2013a). Reinstating access to health care for refugee claimants. Ontario Government. Retrieved from
  38. Ontario Government (2013b). Backgrounder—Ontario temporary health program. Ontario Government. Retrieved from
  39. Oscapella, T. (2013 February 27). Refugee groups taking federal government to court over refugee health care cuts. Canadian Civil Liberties Association. Retrieved from
  40. Radio Noon Montreal (2012 June 28). Quebec will fund refugee care. CBC Radio. Retrieved from
  41. Radwanski, A. (2013 March 29). For Ontario Liberals, early peacekeeping might lead to long-term challenges. The Globe and Mail. Retrieved from
  42. Rice, W. (2011). Health promotion through an equity lens. The Wellesley Institute. Retrieved from
  43. Samon, L. & Hui, C. (2012). Cuts to refugee health program put children and youth at risk. Canadian Pediatric Society. Retrieved from
  44. Sanders, C. (2012 October 13). Province steps up for refugees. Winnipeg Free Press. Retrieved from
  45. Spur, B. (2012 July). Refugee health cuts sicken doctors. Now Toronto, 31(45). Retrieved from
  46. Toth, J. (2010). The incomprehensible flow of Roma asylum-seekers from the Czech Republic and Hungary to Canada. Centre for European Policy Studies. Retrieved from
  47. University of Toronto Department of Psychiatry (2012). Interim Federal Health Program cuts and Bill C-31—U of T Psychiatry position statement. University of Toronto. Retrieved from
  48. Wales, J. (2010). Interim federal health: a public perspective. Commentary, 7(1), 50–52. Retrieved from
  49. Woods, M. (2013). Doctors, lawyers to challenge conservative refugee healthcare cuts. O-Canada. Retrieved from

Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  1. 1.Factor-Inwentash Faculty of Social WorkUniversity of TorontoTorontoCanada
  2. 2.Factor-Inwentash Faculty of Social Work and School of Public Policy and GovernanceUniversity of TorontoTorontoCanada

Personalised recommendations