Canada’s refugee health law and policy from a comparative, constitutional, and human rights perspective

Under the Interim Federal Health Program (IFHP), Canada has provided healthcare coverage for immigrants in financial need, including refugees, for over half a century. Until recently, the program provided migrants with comparable coverage to that available to Canadians on social assistance. In 2012, the government amended the IFHP to significantly reduce coverage for certain classes of migrants, including some on the basis of their country of origin, and removed coverage from others altogether. This article briefly describes the changes in migrant healthcare coverage in Canada, and compares it with analogous coverage in the United States, the United Kingdom, and Australia. The comparison demonstrates that Canada’s recent changes to healthcare coverage fall below a common standard of coverage in these comparator countries. The paper then explores arguments made for and against the constitutionality of the revised IFHP in Canadian Doctors for Refugee Care v Canada, and the consistency of the plan with Canada’s obligations under international human rights law. The authors contend that despite the reluctance of courts thus far to recognize a positive duty on the part of the state to provide health benefits as a means of protecting Charter rights, facets of this case present unique and compelling reasons for doing so. Finally, the paper argues that restoring coverage to levels prior to 2012 would bring Canada in closer conformity to the values and principles expressed in various international human rights treaties.