Canada's Interim Federal Health Program (IFHP) is in the spotlight after a major report from the Parliamentary Budget Officer (PBO). This federal program provides temporary healthcare to asylum claimants, refugees, and other newcomers who aren't yet covered by provincial health plans.
- 01What Exactly Is the Interim Federal Health Program (IFHP)?
- 02The Massive Cost Surge: From $211 Million to $896 Million
- 03IFHP spending growth
- 04Why are costs rising so quickly?
- 05What services do refugees and claimants receive?
- 06How does this compare to health access for Canadians?
- 07Canadians without a family doctor
- 08Patients dying on waitlists
- 09Perceived disparity
- 10New co-payments for refugees and asylum seekers
- 11What the Parliamentary Budget Officer projects for 2029‑30
- 12Political debate and Health Committee concerns
- 13What this means for ordinary Canadians
The latest figures show costs have exploded from $211 million in 2020-21 to $896 million in 2024-25 – that's a 325% jump in just four years. And it's not stopping. The PBO projects the program will cost nearly $1 billion in 2025-26 and top $1.5 billion every year by 2029-30.
In simple terms: Taxpayers are footing a bigger and bigger bill for healthcare for people seeking refuge in Canada. But with millions of Canadians struggling to see a doctor, many are asking if this is fair. Let's break it all down in easy-to-understand language, with all the key data, facts, and numbers.
What Exactly Is the Interim Federal Health Program (IFHP)?
The IFHP is a federal government program run by Immigration, Refugees and Citizenship Canada (IRCC). It acts like a "bridge" healthcare plan for certain people new to Canada.
Who does it cover?
- Asylum claimants (people who arrive in Canada and ask for refugee protection).
- Resettled refugees (those approved before arriving).
- Some other vulnerable groups, like immigration detainees.
In 2024-25, it served 623,365 people – that's more than the population of cities like Quebec City or Saskatoon. About 440,000 of them were asylum claimants.
What does it pay for?
- Basic care (fully covered, no extra cost to the person): Doctor visits, hospital stays, lab tests, and emergency care.
- Supplemental benefits (extra services): Prescription drugs, dental care, vision care (glasses), counselling, physiotherapy, speech therapy, home care, and assistive devices like wheelchairs.
Coverage lasts until the person gets provincial health insurance, leaves Canada, or their claim is fully processed. Even rejected asylum claimants keep getting benefits until they actually leave the country.
This program is meant to help vulnerable people avoid spreading diseases or facing health crises while their status is sorted out.
The Massive Cost Surge: From $211 Million to $896 Million
Here's how the costs have grown, based on official PBO data:
IFHP spending growth
Key facts on the rise:
- Costs grew 33.7% per year on average from 2020-21 to 2024-25.
- Two main reasons: More people using the program (beneficiaries jumped from about 85,000 in 2016-17 to over 600,000 now) and higher costs per person (due to more services used and rising healthcare prices).
- Asylum claims spiked in recent years, but slowed in 2025 (down to 108,060 new claims from 190,000+ the year before).
The PBO says future growth will slow to 11.2% per year, but it will still hit $1.5 billion annually by the end of the decade.
Why are costs rising so quickly?
The PBO and government documents identify several key drivers behind the surge in IFHP spending.
- More asylum claims and slow processing
- Asylum claim intake has been very high; although it moderated recently, it still exceeds the system’s capacity to process and finalize claims.
- In 2025, about 108,060 asylum claims were referred to the Refugee Protection Division, down from 190,483 in 2024, but still high enough that the number of people in the system keeps growing.
- As long as claims are not finalized, many claimants remain eligible for IFHP, so delays translate directly into more beneficiaries and more months of coverage.
- Much larger client base
- Higher costs per person
- Since 2016‑17, the cost per in‑Canada beneficiary has been rising quickly, partly because of increased use of services and higher health costs.
- The PBO expects this per‑person cost growth to stay elevated for a while but gradually converge toward broader per‑capita health‑care spending growth in Canada.
- Expanded benefits and billing issues
- Conservative MPs and witnesses at the Health Committee have flagged that supplemental benefits—such as vision care, physiotherapy, home care, and speech therapy—are available under IFHP after Liberal‑era program expansions.
- Some doctors testified that providers can bill up to five times the provincial fee schedule rates under IFHP, raising concerns about over‑billing and limited oversight.
What services do refugees and claimants receive?
IFHP benefits can be grouped into three broad categories.
- Basic health care
- Supplemental health benefits (depending on category and eligibility)
- Prescription drugs and vaccines
- Urgent dental care (for pain, infection, trauma)
- Vision care such as eye exams and sometimes limited eyewear support
- Mental health services, some psychological counselling
- Rehabilitation services like physiotherapy, certain home‑care supports, and in some cases speech therapy
- Pre‑departure and travel‑related medical services
One of the most controversial points is that rejected asylum claimants can remain covered for certain services while they are still physically present in Canada and have not yet left, especially if removal is delayed. Critics argue this effectively provides relatively generous coverage to people who have been determined not to need Canada’s protection, so long as they remain in the country.
How does this compare to health access for Canadians?
The political backlash is driven largely by comparisons between IFHP coverage and the serious gaps faced by Canadian citizens and permanent residents in the public system.
Canadians without a family doctor
Conservative statements often cite that about 6–6.5 million Canadians do not have a family doctor. While precise numbers vary by survey and province, multiple reports have flagged a growing shortage of primary‑care providers, especially in Ontario, British Columbia, and Atlantic Canada. Many Canadians rely on walk‑in clinics and emergency rooms for basic care, and some regions have waitlists for attaching patients to family physicians.
Patients dying on waitlists
A major data point fuelling anger is a new report from Canadian think tank SecondStreet.org.
- Government data obtained through freedom‑of‑information requests show at least 23,746 patients died while on waitlists for surgeries or diagnostic scans in the most recent fiscal year analyzed.
- The total count of Canadians who have died while waiting for care since 2018 is now over 100,000, based on the same FOI‑based series of reports.
- In jurisdictions with comparable data from the previous year, deaths on waitlists increased by about 3%.
Importantly, these figures include deaths that occurred while patients were still waiting; the datasets usually do not determine whether the wait directly caused the death, but they illustrate how overwhelmed the public health system has become.
Perceived disparity
Conservative MPs argue that rejected or “bogus” asylum claimants now receive supplemental health benefits—such as vision care, physiotherapy, home care and speech therapy—that millions of tax‑paying Canadians cannot easily access or must pay for privately. They frame this as “better healthcare than many Canadians who have paid into a system their entire life,” especially while family‑doctor shortages and long surgical waitlists persist.
New co-payments for refugees and asylum seekers
In response to escalating costs and political pressure, the federal government has introduced co‑payments for certain IFHP services.
Key points from official notices:
- Basic health services—such as medically necessary doctor visits and hospital care—remain fully covered with no co‑payment required.
- Co‑payments apply to some supplemental benefits, such as certain prescription drugs, dental services, vision care, and other non‑emergency supports.
- These co‑payments are set to begin in 2026 (the official IRCC notice specifies start dates and categories) and are meant both to curb costs and to align IFHP more closely with what many Canadians pay through out‑of‑pocket expenses or private insurance.
Advocacy groups worry that these co‑payments will discourage low‑income refugees and asylum claimants from accessing essential services like medications, dental care and mental‑health supports, potentially leading to worse health outcomes and higher emergency costs later.
What the Parliamentary Budget Officer projects for 2029‑30
The PBO’s central projection gives a detailed picture of where IFHP spending is heading if current trends continue.
- Total IFHP costs are expected to reach nearly $1.0 billion in 2025‑26 and rise to more than $1.5 billion by 2029‑30.
- The number of beneficiaries is assumed to remain high, as asylum claim intakes stay near current levels and processing capacity does not meaningfully catch up.
- Average cost per beneficiary is projected to grow from $1,363 in 2024‑25 to about $2,148 in 2029‑30, driven by higher health costs and continued use of services.
- Administrative and other overhead are assumed to stay around 3.4% of total program costs, based on historical trends.
The PBO stresses that there is significant uncertainty around these projections, especially about future asylum‑claim volumes and policy changes, but notes that the main drivers are structural: high inflows and limited adjudication capacity.
Political debate and Health Committee concerns
The House of Commons Standing Committee on Health (HESA) requested the PBO analysis in November 2025 to better understand what is behind the “significant cost and usage increases” in the IFHP. The committee has heard testimony from physicians, experts and officials about:
- High billing rates under IFHP compared with provincial fee schedules
- Possible program exploitation due to weak oversight and auditing
- The strain on provincial systems when newcomers arrive with complex health needs
Conservative members have used the PBO numbers to argue that the federal government has “lost control” of both immigration and health‑care planning, pointing to the combination of:
- Rapid population growth from temporary residents and permanent immigration
- Serious capacity constraints in provincial health systems
- Rising IFHP costs and broader health‑care spending pressures
At the same time, refugee advocates and some health experts emphasize that IFHP is a relatively small piece of Canada’s overall health budget and that providing basic care to vulnerable newcomers can prevent more expensive crises later. They also note that many asylum seekers and refugees contribute economically and pay taxes once they are able to work, helping support public services in the long run.
What this means for ordinary Canadians
For a general reader, the key takeaways are:
- IFHP is only one program in Canada’s health‑care landscape, but its costs are rising quickly and are projected to cross $1.5 billion per year by 2029‑30.
- The surge in costs is mainly due to more asylum claimants, slow processing that keeps people in the system longer, and rising health‑care prices per person.
- At the same time, millions of Canadians struggle without a family doctor, and nearly 24,000 patients a year are dying while on waitlists for surgeries and diagnostic tests, highlighting system‑wide strain.
- New co‑payments for refugees and asylum seekers aim to reduce IFHP costs and align the program more closely with what Canadian residents face, but they risk creating new barriers for vulnerable people.
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