The Immigrant Algorithm examines a central contradiction in Canada’s policy landscape. Although Canada is widely recognized for its commitment to universal healthcare and humanitarian protection, asylum seekers, also referred to as refugee claimants, often experience healthcare access as conditional, uneven, and unstable.

The Problem

This contradiction is not simply the result of isolated barriers or administrative inefficiencies. It reflects deeper structural tensions within healthcare and immigration systems, including fragmented governance, complex administrative processes, and uncertainty in how policies are implemented in practice. As a result, access to care is not guaranteed by formal eligibility alone, but shaped through institutional processes, frontline decision-making, and broader social and policy dynamics.

How the System Works

Healthcare access for asylum seekers in Canada is governed through a multi-level system. Immigration and refugee policy fall under federal jurisdiction, while healthcare delivery is primarily managed by provinces. Asylum seekers do not have immediate access to provincial insurance programs such as OHIP. Instead, their coverage is provided through the Interim Federal Health Program (IFHP), a federal program that offers temporary and limited healthcare benefits.

This division creates a fragmented system in which federal eligibility rules must operate within provincial healthcare structures. In practice, this can result in gaps in coordination, provider uncertainty, delays in care, and inconsistent access across institutions and settings.

Research Focus

This research moves beyond identifying barriers to care. It examines how those barriers are produced through policy design, governance arrangements, administrative practices, and institutional decision-making. The focus is on asylum seekers in Ottawa, where these dynamics are particularly visible.

Core Question

How do governance structures, administrative practices, and narratives of deservingness shape asylum seekers’ access to healthcare under the Interim Federal Health Program in Ottawa?

How Barriers Are Produced

Barriers to healthcare access are produced across multiple levels of the system. Policy design establishes eligibility criteria and coverage limits. Administrative systems introduce complexity through documentation requirements, reimbursement processes, and verification procedures. At the frontline, healthcare providers and administrators interpret and apply these rules under conditions of uncertainty, shaping access in practice. Together, these layers produce uneven and conditional access to care.

Key Themes

Key themes include the Interim Federal Health Program, federal and provincial healthcare systems, intergovernmental fragmentation, administrative complexity, provider uncertainty, legal precarity, service-level barriers, navigation challenges, and the role of lived and community knowledge. The research also examines how narratives of deservingness influence policy, institutional practice, and access to care.

Key Concepts

The study draws on several core concepts. Social citizenship frames healthcare as a social right linked to inclusion within society. Conditional belonging describes how access to that right may be partial or unstable. Intergovernmental fragmentation refers to the division of responsibilities across federal and provincial systems. Street-level decision-making highlights the role of frontline actors in shaping how policy is applied in practice. Together, these concepts help explain how healthcare access is structured and experienced.

Approach

The project draws on social citizenship theory, critical governance, migration and health research, and intersectional analysis. It examines the relationship between policy and lived experience, with attention to how access is negotiated through institutional routines, administrative systems, and broader ideas about belonging and deservingness.

From Research to Action

The research informs two linked public-facing events. The roundtable creates space for dialogue across research, policy, practice, and lived experience. The workshop then builds on that discussion through collaborative analysis, reflection, and practical knowledge mobilization.

Explore the Roundtable
Explore the Workshop

Why Ottawa

Ottawa provides a critical setting for this work. Healthcare access in the city is shaped by federal programs, provincial systems, municipal realities, and a dense network of community organizations. This makes visible how multi-level governance and institutional fragmentation affect asylum seekers’ access to care in practice.

Knowledge Mobilization

This project is designed not only to analyze inequities, but to translate research into forms that are usable by policy audiences, practitioners, community organizations, and those directly affected. It emphasizes dialogue, synthesis, collaborative reflection, and dissemination strategies oriented toward practical impact.