Protecting refugees’ health: How is the reinstated Interim Federal Health Program working?
AUTHORS Brandon Chen
Publicly-funded health care for refugees and refugee claimants in Canada is provided through the Interim Federal Health Program (IFHP). After experiencing extensive cuts in June 2012, IFHP was restored in April 2016. There is presently limited information on how the reinstated IFHP is meeting its purported objective of, among others, protecting refugees’ and refugee claimants’ health and safety. As a step toward filling this gap in the literature, our research team conducted a pilot study in 2017 with refugee-serving practitioners in the City of Ottawa. We found the current IFHP, despite significant improvements from the years of cuts, falls short in several aspects. A legacy of confusion about the IFHP persisted among service providers, and the processes for service providers to register in and to seek reimbursement from the IFHP was seen as burdensome. Anecdotal evidence indicated that these ongoing problems were hindering IFHP beneficiaries’ timely access to quality health care.
Motivated by findings from the pilot study, further research was conducted between July 1, 2018 and July 31, 2020 to better gauge IFHP’s current performance. Four inter-related themes emerged from these interviews: (1) IFHP illiteracy; (2) coverage gaps under IFHP; (3) health access barriers facing IFHP beneficiaries; and (4) administrative hurdles facing IFHP service providers. These themes largely echoed the findings of the pilot study. Together, they showed that IFHP’s reinstatement alone had not completely eliminated the health care access challenges that refugees and refugee claimants faced during the years of IFHP cuts.
For both beneficiaries and service providers, a high level of confusion about the content of IFHP was observed. This negatively affected IFHP beneficiaries’ comfort with accessing health care, as well as service providers’ willingness to take on IFHP clients. As a result, even under the current IFHP, some beneficiaries still struggled with finding service providers that would accept them as patients, and they sometimes were asked to pay for health care services or products that should have been publicly covered.
How does this research apply to my work?
The research found that familiarity with IFHP appeared prevalent among refugee-serving practitioners. Even when service providers knew of IFHP, however, they were not always knowledgeable about the workings of the program.
Commonly, service providers’ confusion about IFHP concerned the basket of health care services and goods it covered, what served as acceptable documents for confirming a person’s IFHP eligibility, the duration of IFHP coverage and how it interfaced with expiration dates listed on IFHP documents, and the process for seeking reimbursement from Medavie Blue Cross.
What should I take away from this research?
Confusion about IFHP was said to have had the effects of tarnishing refugees’ and refugee claimants’ health-seeking experience. Several IFHP beneficiaries complained about having to wait longer than others before being served by health care providers because the providers did not immediately know what IFHP was or how to process IFHP coverage.
At times, IFHP illiteracy might even impede refugees and refugee claimants from accessing certain health care completely. In other cases, IFHP beneficiaries were denied access to health care because of service providers’ misinformation or confusion about the program.
What’s the next step?
Going forward, the Canadian government must devote more attention to educating refugees, refugee claimants and service providers about IFHP and to answering their questions about the program. Such public education must be done in a way that is carefully tailored to the needs and circumstances of the specific audience. For example, when information about IFHP is communicated to refugees and refugee claimants, it should be translated/interpreted and laid out in plain language.
As much as it is important to inform beneficiaries and providers the services or products covered by IFHP, it would be equally helpful to have the differences in coverage between IFHP and other publicly-funded health insurance programs clearly explained. Moreover, to the extent that service providers’ negative perceptions about IFHP are inaccurate, it would be critical for the government to counter these myths with facts. Alternatively, if complaints about IFHP’s billing and coverage gaps are on point, their timely resolution by government will be key to ensuring that IFHP accomplishes the objectives of protecting refugees’ and refugee claimants’ health and safety.