Cutting the Interim Federal Health Program is the wrong prescription for cost savings in health care

The strength of a health care system can be measured by its commitment to those who need it most. For decades, the Interim Federal Health Program (IFHP) has served as a critical, albeit temporary, safety net for refugees, asylum seekers, and others fleeing violence while they await provincial coverage. Many of these families are fleeing persecution and humanitarian disasters in settings where health care and social systems are non-existent or inaccessible. Often, prioritizing safety and other basic needs means that physical and mental health concerns have gone unmet. For these families, Canada offers the promise of a new start.

The federal government’s recent announcement to introduce co-payments for “supplemental” health care products and services, effective 1 May 2026, marks a concerning shift that risks the health and well-being of these newcomers.[1] Patients will be required to cover a $4 co-payment for every prescription and 30% of the cost of supplemental services, including dental care, vision care, and mental health counseling. Immigration, Refugees and Citizenship Canada (IRCC) has framed these changes as necessary for “long-term sustainability.”

Professional associations and advocacy groups have spoken out about the deep problems inherent in the IRCC’s position, decrying the negative impact on affected families and underscoring the duty to uphold basic rights to health care.[2] The policy change is wrong, not only from a human rights perspective, but also from an economic one. While the revised program provides funding for doctor and hospital visits, co-payments for the treatments we prescribe constitute a major barrier to accessing the medicine patients need to stay healthy. We know that co-payments prevent the use of essential treatments and have measurable morbidity and mortality risks.[3,4] Social determinants of health such as poverty and trauma, which affect many IFHP beneficiaries, amplify those effects. The combined impact will result in a need for more emergency room visits, more in-patient hospital stays, more physician time, and, ultimately, higher costs overall. Shifting the financial load from one silo to another is cost shuffling, not cost saving.

None of this is new. In 2012, the federal government repealed the IFHP, once again claiming that cuts would decrease health care costs. Research from Ontario following those cuts found that while the number of emergency room visits by refugee children decreased, the admission rate nearly doubled, from 6.4% to 12.0%.[5] Children were presenting sicker, because they could no longer access or afford the preventive care and medications that keep chronic conditions stable.

While the harm will be felt most directly by IFHP patients whose supports are cut, the wider threats to Canadian health care will affect us all. By pushing people who are unable to afford entry-level access to care into clogged emergency departments and hospitals bursting with patients, the IRCC decision tightens critical bottlenecks in an already overstretched health system and makes it harder for everyone to access what they need.

To sustain the health care system for future generations, there is no doubt that we need innovation to address the rising costs and demands; however, limiting the care provided through the IFHP is not the answer.
—Kristopher Kang, MD, FRCPC

References

1.    Immigration, Refugees and Citizenship Canada. Changes to the Interim Federal Health Program. 27 January 2026. Accessed 27 February 2026. www.canada.ca/en/immigration-refugees-citizenship/news/notices/changes-ifhp.html.

2.    Sauvé L, Hui C, Suleman S, et al. Letter to Hon. Lena Metlege Diab, Minister of Immigration, Refugees and Citizenship. Canadian Paediatric Society. 20 February 2026. Accessed 1 March 2026. https://cps.ca/uploads/advocacy/Changes_to_IFHP.pdf.

3.    Newhouse JP, Insurance Experiment Group. Free for all? Lessons from the RAND Health Insurance Experiment. Cambridge, MA: Harvard University Press; 1993.

4.    Chernew M, Gibson TB, Yu-Isenberg K, et al. Effects of increased patient cost sharing on socioeconomic disparities in health care. J Gen Intern Med 2008;23:1131-1136. https://doi.org/10.1007/s11606-008-0614-0.

5.    Evans A, Caudarella A, Ratnapalan S, Chan K. The cost and impact of the Interim Federal Health Program cuts on child refugees in Canada. PLoS One 2014;9:e96902. https://doi.org/10.1371/journal.pone.0096902.