What are the changes to Canada’s medical inadmissibility rules?

13 December 2017

Minister of Immigration, Refugees and Citizenship, Ahmed Hussen, announced on November 23, 2017 that there would be changes coming to Canada’s medical inadmissibility rules.

Currently, under section 38(1)(c) of the Immigration and Refugee Protection Act, foreign nationals are deemed inadmissible to Canada on health grounds if their health condition is reasonably expected to cause excessive demand on health or social services over a period of five consecutive years immediately following the most recent medical assessment.

Excessive demand is defined under section 1(1) of the Immigration and Refugee Protection Regulations (IRPR). It is a multifaceted definition, which considers excessive demand on health or social services for which the anticipated costs would likely exceed the average Canadian per capita health services and social services costs. Excessive demand is also defined as adding to the existing waiting lists and would increase the rate of mortality and morbidity in Canada as a result of the denial of or delay of those services to Canadian citizens or permanent residents. Every year Immigration, Refugee and Citizenship Canada (IRCC) releases an excessive demand threshold based on the current estimated amount used by Canadians citizens and permanent residents. If a foreign national’s health condition exceeds the threshold, they will be deemed inadmissible to Canada for health grounds.

In 2017, the excessive demand cost threshold was $6,655 per year. This figure is usually multiplied by five (unless the anticipated length of stay is shorter than five years or there is evidence that significant costs are likely to be incurred beyond that period, in which case the period is no more than 10 consecutive years). This results in the legislated threshold of $33,275 for the five-year period.  This cost threshold is considered relatively low , and therefore, many potential immigrants get impacted and are considered inadmissible to Canada.

However, Minister Hussen has noted that decisions based on the excessive demand rules result in an estimated annual savings of $135 million, which only represents 0.1% of all health spending in Canada.

The Standing Committee on Citizenship and Immigration is now reviewing the excessive demand policy, which has been in place for over 40 years. Minister Hussen noted that the provision is not in line with the government’s policies with respect to moving towards its goals of accessibility and inclusiveness.

Although Mr. Hussen was vague about what changes would be coming to the provision, he did say that “all options are on the table,” including completely removing the excessive demand rule altogether. However, Minister Hussen stressed that the medical examination required by applicants for many of the immigration programs, will remain in place. The committee is expected to continue the hearings on medical inadmissibility into the new year before releasing a full report with final recommendations. 

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