Immigration reform with implications for health
Bill C-12, officially titled the Strengthening Canada’s Immigration System and Borders Act (Loi visant à renforcer le système d’immigration et la frontière du Canada), was introduced by the government as a measure to strengthen the immigration and asylum system. According to the official text, it includes new measures regarding eligibility for asylum claims and changes to the management of immigration documents and information.
An office of Immigration, Refugees and Citizenship Canada.
Photo: Radio-Canada / Ivanoh Demers
Ottawa also announced changes to the Interim Federal Health Program (IFHP), the temporary health coverage for certain refugees and asylum seekers. The program will continue to cover basic care, but from 1 May 2026, co-payments are expected for medicines and other supplementary services. For doctors, shelters and civil society organisations, this change could result in delays, debt, and postponed treatments.
Concerns from the health professionals’ perspective
Tatiana Freire Lizama, an obstetrician-gynaecologist and perinatologist at St. Michael’s Hospital in Toronto, bases her criticism on her day-to-day experience with patients who have recently arrived in Canada, many of whom are pregnant and struggling to access medication.
That program covers the cost of medication for refugee women, but that is going to change because they will have to pay part of that cost, and that is extremely difficult.A quote from Tatiana Freire Lizama, obstetrician-gynaecologist and perinatologist at St. Michael’s Hospital.
The doctor, who took part in a demonstration involving around 100 healthcare professionals, refugees, and community organisations in Toronto on 27 March outside the office of MP Julie Dzerowicz, explained that the problem is not merely financial.
In her practice, many patients arrive without speaking one of the official languages, without a job and, sometimes, without stable housing. In this context, she said, imposing co-payments can lead to delayed treatment or patients failing to purchase their prescribed medication.
“What happens is that they become more ill, and when they can no longer cope with their condition, they present in a more acute state upon arrival at the hospital and end up in A&E and admitted to hospital.”
Tatiana Freire Lizama, obstetrician-gynaecologist and perinatologist at St. Michael’s Hospital.
Freire Lizama also pointed out that this debate is not new. She said there had already been a similar dispute in 2012, when the Supreme Court of Canada ruled that cutting off access to healthcare for refugees constituted cruel punishment and was therefore a measure that could not be enforced.
The perspective from a refugee center
Diana Gallego, director of the FCJ Refugee Centre in Toronto, also criticised the cuts. Her organisation has been working with refugees for 35 years and, as she explained, many of them arrive with trauma that requires medical and psychological support from the outset.
The cruelty behind the cuts to the refugee health programme goes against Canadian values.A quote from Diana Gallego, director of the FCJ Refugee Centre in Toronto
Diana Gallego, pictured holding the microphone, now director of the FCJ Refugee Center, arrived in Canada as an asylum seeker several years ago.
Photo: Cortesía / FCJ Refugee centre
The Colombian-born woman added that many of the people they support at the centre need access to a psychologist or counsellor, as well as basic medical care. In her view, the introduction of these new charges will not solve the budgetary problem cited by the government; instead, it could drive more people to seek hospital treatment only once their condition has worsened.
Many of them come with very traumatic issues stemming from the experiences they have endured and which forced them to leave their countries,
Diana Gallego, director of the FCJ Refugee Centre in Toronto
Diana Gallego, pictured holding the microphone, now director of the FCJ Refugee Center, arrived in Canada as an asylum seeker several years ago.
Photo: Cortesía / FCJ Refugee centre
Gallego summed up her position with a direct appeal to the federal government: Ottawa must restore access to healthcare services for refugees.
Widespread criticism from a civil society coalition
Opposition to the law is not limited to the health sector and organisations providing direct services to refugees.
A broad coalition of human rights, civil liberties, migration, gender justice, and privacy organisations has condemned Bill C-12 for undermining the safeguards that protect the health of refugees and migrants.
The statement also notes that the Senate Committee on Social Affairs, Science and Technology recommended removing parts of the bill on grounds of human rights, privacy, and due process.
Among the voices in this coalition, Tim McSorley of the International Civil Liberties Monitoring Group described it as outrageous and hypocritical that the Canadian government is using the argument of national security and border integrity to adopt regressive and dangerous immigration measures.
Instead of making Canada safer or improving the efficiency of the immigration system, Bill C-12 will put more people in danger, grant the government unaccountable and discretionary powers, and weaken privacy protections for everyone in Canada.A quote from Tim McSorley, International Civil Liberties Monitoring Group
According to him, the Senate Social Affairs Committee was right to recommend that all immigration measures in that legislation be removed. “We will continue to work alongside others in the human rights, civil liberties, and migrant and refugee rights sectors to address the impacts of the legislation and push back against further xenophobic legislation falsely portraying migrants and refugees as security threats,” he added.
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Tim McSorley’s appearance before the Senate Standing Committee on Social Affairs, Science and Technology as part of its review of Bill C-12, prior to its passage, during which he stated that the ‘Strengthening Canada’s Immigration and Border System Act’ infringes on rights and is xenophobic:
Another strong voice within that coalition was that of Julia Sande of Amnesty International Canada, who said that Bill C-12 jeopardises Canada’s self-image – not to mention its international reputation – as a safe and welcoming haven for people fleeing war, persecution and torture.
According to her, by making the refugee protection system less accessible to those who need it, there is a risk of pushing people into terrible situations where they may face violence, discrimination, or even death.
We owe it to them, and to ourselves, to learn from some of the ugliest chapters of Canada’s modern history, to not turn our backs on the world’s most vulnerable people in their time of greatest need.A quote from Julia Sande, from Amnesty International Canada
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The coalition also warned that recent immigration measures are part of a trend towards greater state discretion and the erosion of rights. In this context, it pointed out that the debate on refugees’ health cannot be separated from the broader discussion on protection, privacy, and due process.
The response sought in Parliament
Liberal MP Julie Dzerowicz, of Mexican and Ukrainian descent, in her office at the Canadian Parliament.
Photo: Radio-Canada / Paloma Martínez Méndez
RCI sought comment from MP Julie Dzerowicz, Chair of the Standing Committee on Immigration and Chair of the Toronto Liberal Caucus. Her office replied that it would not be possible to conduct the interview due to scheduling conflicts.
A debate on rights and the healthcare system
For Tatiana Freire Lizama, the central issue remains medical and humanitarian. For Diana Gallego, it is also a question of values and hospitality. For the coalition of organisations, Bill C-12 leaves those who already arrive with few protections even more vulnerable.
And for the government, the reforms are part of an overhaul of the immigration, and healthcare systems. Amidst these positions, the debate has only just begun.
Critics agree on one key point: if Canada restricts access to healthcare for refugees and asylum seekers, the cost will not fall solely on those individuals, but also on hospitals, shelters and the very idea of Canada as a welcoming country that these organisations champion.