Q-958 , 45th Parliament, 1st session May 26, 2025, to present

With regard to the Interim Federal Health Program: (a) what are the projected gross savings of the Interim Federal Health Program co-payment model for 2026–27 and 2027–28, broken down by benefit category (prescription, dental, vision, counselling, devices, etc.); (b) what are the projected administrative costs (including information technology services, system changes, provider communications, call centres, dispute resolution, payment reconciliation and auditing services) of the program for 2026–27 and 2027–28, broken down by fiscal year, and what are the projected net savings after administrative costs; (c) what share of net savings is expected to come from beneficiary payments versus reduced utilization or foregone services; (d) what assumptions has the government made to produce the savings estimate in (c), including the assumed percentage change in prescription fills (by drug class, dental claims, vision claims, counselling claims, assistive device claims and collection failure or non-payment rates), and what evidence did the government rely on for each assumption; (e) what is the projected distribution of co-payment amounts paid per beneficiary ($0, $1–10, $11–25, $26–50, $51–100, $101+, per month), broken down by beneficiary class and province or territory; (f) what are the details of the monthly claims data for the 24 months preceding May 1, 2026, broken down by province or territory and beneficiary class, including the (i) number and value of claims, broken down by benefit category, (ii) number of prescriptions adjudicated and paid, broken down by drug class, (iii) provider participation counts, broken down by provider type (pharmacy, dentist, counsellor, etc.), (iv) denial or rejection rates, broken down by reason; (g) what analysis, including any sensitivity analyses, has Immigration, Refugees and Citizenship Canada conducted to estimate the incremental costs to provincial and territorial systems arising from Interim Federal Health Program co-payments, and what are the details, including the (i) additional costs associated with emergency department visits, hospitalizations, ambulance use and complications from delayed dental and mental health care, (ii) additional costs associated with medications and services used for prevention and treatment of communicable diseases (including tuberculosis, human immunodeficiency virus, hepatitis and sexually transmitted infections), (iii) downstream public health costs (including transmission and outbreak response); (h) how did the government come up with the analyses in (g), and what are the details, including (i) the chosen methodology, (ii) the chosen parameters, (iii) the results, (iv) whether co-payments apply; (i) do co-payments, effective May 1, 2026, apply to resettled refugees, including government-assisted refugees and privately sponsored refugees, and, if so, (i) what is the projected number of Interim Federal Health Program beneficiaries affected in 2026–27, broken down by immigration category and province or territory, (ii) what Charter or compliance analyses were conducted, if any, (iii) what are the estimated costs associated with implementation and potential rollback; (j) for the 2026-27 and 2027-28 fiscal years, what share of projected beneficiary co-payments is expected to be paid by the top 10% of payers, broken down by beneficiary class and province or territory; (k) for the 2026-27 and 2027-28 fiscal years, how many beneficiaries are projected to require (i) three or more, (ii) five or more, (iii) 10 or more, prescriptions per month, broken down by age group and beneficiary class; (l) what is Immigration, Refugees and Citizenship Canada’s projected provider attrition rate attributable to co-payment collection requirements, broken down by provider type and province or territory; (m) what guidance is issued when a beneficiary cannot pay at point of service, including whether care may proceed and any escalation procedures; (n) what mechanisms exist to record “service refused due to inability to pay,” and what reporting will be required; (o) how is the government coordinating with provincial and territorial plans for government-assisted refugees and privately sponsored refugees, and what are the details, including the (i) average, (ii) distribution, of time from arrival to eligibility for provincial health coverage and drug plans, broken down by province or territory; (p) how many Interim Federal Health Program beneficiaries are projected to be eligible for the Canada Dental Care Plan during 2026–27, and what measures exist to prevent duplication of coverage or coverage gaps; (q) what modelling exists on cost shifting between the Interim Federal Health Program, provincial pharmacare and youth drug programs; (r) what are the projected reductions in Interim Federal Health Program costs under scenarios where Immigration and Refugee Board of Canada processing times are reduced by 25%, 50%, 75%, (or to specified service standards), and what is (i) the projected cost of additional Immigration and Refugee Board of Canada capacity required for each of the above scenarios, (ii) the net fiscal impact of backlog reduction scenarios versus co-payment savings; (s) what indicators will Immigration, Refugees and Citizenship Canada track (or model) regarding changes in workforce participation attributable to reduced access to medication, vision care, assistive devices, and mental health services; (t) did Employment and Social Development Canada, the Public Health Agency of Canada, or Finance Canada do intergovernmental analysis on the impacts in (s), and, if so, what were the findings; and (u) what modelling exists on increased disability-related costs arising from foregone supplemental care?