January 15, 2014
Ontario Reinstates Healthcare Coverage for Refugees
On January 1st 2014, Ontario followed the lead of four other Canadian provinces to reinstate healthcare coverage for refugees who have been denied medical care once provided by the Canadian federal government. Alberta, Manitoba, Nova Scotia, and Quebec have already put temporary programs in place to ensure that refugee claimants at any stage of their asylum process are able to access basic, supplementary and emergency healthcare services.
Comprehensive medical coverage for refugees was widely available in Canada for many decades under the Interim Federal Healthcare Program of 1957. Access to this program became severely limited in June 2012 when the Minister introduced strict new eligibility criteria that have left a vast number of refugees without access to healthcare services.
Since 2012, if a refugee claimant is from a country of origin that is deemed to be “safe” then he or she is no longer covered under Canada’s IFHP, unless the medical condition poses a threat to public health and safety. These so-called “safe” countries are places Canada has deemed it is less likely that a person will experience persecution. Hungary and Mexico for instances are countries on the safe list from which Canada has recently received a large volume of refugees. Refugee claimants from countries not on the safe list have access to some limited healthcare services, but medications are among the items not covered. Government sponsored refugees have continued to maintain full healthcare coverage. Until June 2012 all these groups of refugee claimants were treated equally in terms of healthcare services provided. The costs of medical procedures, doctors visits and medications were all covered by the IFHP prior to the 2012 changes.
Legal Challenge
Two professional organizations representing doctors, medical professionals and refugee lawyers have taken a legal challenge to Federal Court arguing that the federal government’s revocation of healthcare coverage for many refugees is not legally valid. Two hearings have already taken place, and a third is scheduled for January 30, 2014. The Canadian Association of Refugee Lawyers and Lawyers for Canadian Doctors for Refugee Care have told the court that the decision was not an Act of Parliament, but was made using the Royal Prerogative. They argue that healthcare and immigration are both governed by law and so override any discretionary powers of the Royal Prerogative.
Along with two refugee claimants personally affected by the cuts to healthcare coverage, these groups of doctors and lawyers challenge that the change in government policy is in violation of the Canadian Charter of Rights and Freedoms. Firstly, the policy discriminates against certain refugees based on their country of origin. Any refugee from a country on Canada’s “safe list” is denied comprehensive healthcare coverage, regardless of their circumstances for seeking asylum. Secondly, although healthcare is not a Charter right, the way the government administers a healthcare system already in place must comply with the Charter. Since complete healthcare coverage for refugees has been in place for many decades in Canada, it is argued that the 2012 decision to revoke coverage is constitutes deprivation.
Also at issue is whether or not the five provinces that have created temporary programs are all offering the same level of healthcare services to refugees. Presently there are still 5 provinces and 3 territories with no measures in place to address the gap in services.
Ontario’s New Program
Ontario itself is home to more than half of Canada’s refugee population, so the introduction of the Ontario Temporary Health Program for refugees is significant both provincially and on a national scale. This program follows the lead of Alberta, Manitoba, Nova Scotia, and Quebec in addressing the gap in healthcare coverage left by the 2012 policy changes of the federal government.
Ontario Health Minister Deb Matthews notes that providing basic and essential healthcare to refugees is more fiscally responsible than waiting until health issues pose a public health risk and must be dealt with in hospital emergency rooms. Providing refugees with access to family health clinics, prescription medications, basic and supplementary healthcare in a comprehensive manner is proactive, humane and ultimately more cost effective for Ontario.
What happens next for refugees in the 5 remaining provinces and 3 territories which do not have temporary programs in place to bridge the gap in healthcare services, will largely depend on the outcome of the challenge before the Federal Court. The next hearing takes place on January 30, 2014.