Excessive demand on health or social services
Statutory definition
IRPA s 38(1)(c) provides that a foreign national is inadmissible on health grounds if their health condition might reasonably be expected to cause excessive demand on health or social services. "Excessive demand" means costs that would exceed the per-capita cost of services in Canada by three times (the 3× threshold), or that would add to waiting lists for services in a way that endangers the health or safety of Canadians. Some permanent residence classes (family class spouses, dependent children, refugees) are exempt from the excessive demand requirement.
Explanation
The excessive demand health requirement changed significantly in 2018 — family class applicants (spouses, partners, dependent children) are now exempt. The 3× cost threshold means that most minor medical conditions do not trigger inadmissibility; only conditions expected to require very high-cost ongoing treatment (organ transplants, dialysis, intensive special education support) typically meet the threshold. Medical officers conduct the assessment, and applicants have the right to respond to an excessive demand finding before a final decision is made.