Redefining Excessive Demand in Medical Inadmissibility Assessments.

On March 27, 2021 in a Regulatory Impact Analysis Statement published in the Canada Gazette, the Department of Citizenship and Immigration identified fundamental issues with the Immigration and Refugee Protection Regulations take on the excessive demand element of medical inadmissibility and suggest regulatory amendments to implement a public policy in force since June 2018.

What is Medical Inadmissibility?

Anyone who applies to immigrate to Canada must be medically admissible. This means that they have no medical condition that makes them inadmissible. As part of an application to immigrate to Canada, the applicant along with all accompanying and non- accompanying family members must undergo a medical examination, used to determine any inadmissibility.

There are 3 possible reasons why someone may be deemed medically inadmissible to come to Canada. These are:

1. They are a danger to public health;
2. They are a danger to public safety;
3. They have a medical issue which will result in an excessive demand on health or social services (in certain cases).

What are the Issues to be addressed?

The statement identifies the issues with the current excessive demand provision. These are:

1. The excessive demand cost threshold, as defined in the existing Regulations, poses a barrier to immigration for some applicants- the original policy screens out people who, despite their health condition or their disability, would be able to make a contribution to the social and economic fabric of Canada;
2. The original policy on excessive demand on health and social services, as currently reflected in the Regulations, is not aligned with the Government of Canada’s position that inclusion and diversity benefit Canadian society;
3. Having medical officers review all information, including non-medical information, is inefficient and is not aligned with the expertise of medical officers, raising questions as to the program’s integrity.

What Would the Regulatory Proposal do?

The proposal aims to:

1. Increase the excessive demand cost threshold for foreign nationals seeking to come to Canada on a temporary or permanent basis to three times the Canadian average cost per person;
2. Redefine “health services’’ and “social services” to, respectively, provide clarity and remove the reference to certain social services, including special education services; and
3. Clarify which officers are responsible for reviewing medical and non-medical information submitted by applicants in the context of excessive demand assessments.

What does this mean for immigrants to Canada?

In June 2018, the government of Canada announced substantial changes to the excessive demand provision, via a temporary public policy which has resulted in more applicants and family members with “manageable” health conditions, who would have been refused entry in the past, come to Canada, where they can integrate into Canadian society and make economic contributions. These proposed regulatory amendments will reflect the changes already implemented through this public policy.