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Many clients Dr. Allison Henderson treats at the Refugee Health Clinic in London, Ont., have fled war, persecution and violence, arriving with little money and no place to call home.
Nearly 100 new refugees come through the clinic’s doors each month seeking care for a variety of complex health issues, said Henderson, the clinic’s medical lead.
Now, the federal government is requiring refugee claimants to pay out of pocket for some medical services that were previously fully covered by the Interim Federal Health Program (IFHP).
Henderson says the decision will push patients into more precarious health situations and further strain an already overwhelmed emergency system.
“I think what worries me about the rhetoric I’m hearing from the government is sort of, ‘Well, we need to equalize things,’ like, ‘Everyone should have to pay a bit.’ And it feels like it’s a race to the bottom,” said Henderson.
The IFHP provides health care to refugees before they are eligible to receive provincial health insurance. London’s clinic, part of London InterCommunity Health Care, offers primary care to patients in their first year in Canada, after which they must seek a long-term care provider in the city.
What is the new co-pay model?
Starting May 1, Ottawa introduced a co-pay model under the IFHP. This means refugee claimants now have to pay $4 for prescriptions and 30 per cent for “supplemental” health services such as mental health counselling, emergency dental, or basic vision care, as well as medical devices such as hearing aids, wheelchairs or prosthetic legs.
Basic essential and emergency services are still fully covered under the program, including vaccinations, lab tests, and ambulance services.
Although the federal government refers to the change as “co-payments,” Henderson says many refugees do not have money to pay for their health care.
She points to one patient with cerebral palsy who has difficulty swallowing and cannot afford outpatient therapy after just arriving in Canada.
“This will mean that we are at a higher risk of choking, of having an aspiration, of having pneumonia, of ending up in hospital,” she said.
Government says changes will save money
There is a growing backlog of people seeking asylum in Canada.
The federal government says the IHFP provided coverage to more than 623,000 people in 2024-25, costing about $896 million.
In a statement to CBC News, Immigration, Refugees and Citizenship Canada said introducing these changes is expected to generate around $127 million in savings in 2026-27 and $232 million onwards.
Henderson says officials have not provided data to support those projections.
“They haven’t provided us any data to back up what their analysis is as to why they think this will save costs,” she said. “They did tell us there wasn’t any expert consultation in this decision.”
She argues the policy will ultimately cost more, as patients delay care until conditions become emergencies.
Henderson hopes the government reverses its decision, and there’s already a precedent for this.
In 2012, Stephen Harper’s Conservative government also reduced coverage provided by the IFHP. A legal challenge was filed against the cuts, and a federal court justice ruled in 2014 that the changes violated Section 12 of the Charter.
That ruling was appealed by the Harper government, but the appeal was abandoned when Justin Trudeau entered office.
When Henderson began working at the refugee clinic 10 years ago, she saw about 30 to 40 new arrivals to the clinic per month, about half the number of people she sees now. Henderson is working with her patients and other organizations to try to mitigate harm, but the patients she has spoken with feel abandoned and neglected by the new cuts, she said.
“It feels like one more place where we are pulling back as a society and we’re all starting to look inward and only think about ourselves and only care about ourselves,” said Henderson.
“There’s a quote about how, you know, you can judge a society by how they take care of the least of those. And I would say when we move in this direction, it gives me a sick feeling in my stomach.”