First Nation leaders and healthcare providers in northwestern Ontario are demanding urgent federal reform of the Non-Insured Health Benefits (NIHB) program, a federal insurance scheme that covers medical transportation, accommodations and meals for Indigenous people who must travel hundreds of kilometers to access health services not available in their home communities.
According to a report of CBC, more than 100 people gathered outside the Indigenous Services Canada (ISC) office in Sioux Lookout, Ontario, calling for a complete overhaul of a program they said is failing the communities it was designed to serve.
"Canada's worst insurance company. Their objective is not to keep you well or to keep you alive. Their job and their objective is to operate within the regional envelope that they get every year that is it," said Nishnawbe Aski Nation (NAN) grand chief Alvin Fiddler.
Meanwhile, Wayne Moonias, former chief of Neskantaga First Nation, which organized the rally, said the problems were systemic and widespread.
"The system and the issue is not getting any better, despite the fact that there's been commitments made from the government on improving the service," he said. "This is not just a Neskantaga issue; it's right across the northern First Nation communities."
As of March 2025, more than 983,000 First Nations and Inuit clients were eligible for the NIHB program, and the federal government has spent an average of $1.87 billion per year on it over the last five years. The federal government announced $764 million in NIHB funding for the 2026-27 year in April, the news outlet previously reported.
Despite that spending, community members and health-care providers say the program's medical transportation function has deteriorated sharply in recent months, with travel arrangements either not being made in time or being communicated to recipients at the last minute.
Anna Banerji, a pediatrician who provides regular services in Sioux Lookout, said the breakdown was having direct clinical consequences. She described cases where patients received same-day notice to travel for specialist appointments, making it impossible for those with caregiving responsibilities or employment to comply.
"The program needs to be fixed and as soon as possible, because anywhere else, other Canadians would absolutely not tolerate it," she said, as reported by CBC.
The impact on health-care providers has been severe. Banerji recounted a conversation with a general surgeon in Sioux Lookout who had four pages of patients booked for procedures and saw only one show up because the others had not been transported to their appointments.
Joseph Dooley, chief of staff at the Sioux Lookout Meno Ya Win Health Centre, flagged a punitive consequence for missed appointments. When patients fail to attend, he said, NIHB marks them as "did not show," which can affect their access to future appointments. The issue is particularly acute for expectant mothers, whose pre-birth travel is classified as elective by the program and not always prioritized.
"These are vital appointments and whether they're going for surgical procedures, diagnostic procedures or to have their baby, it's not acceptable that there is no ability to find out whether or not the insurance company, the travel agency that's supposed to be covering this, is doing their job," Dooley said, as reported by CBC. "They are not doing their job at present."
Despite decades of calls for reform from First Nations leadership, advocates and mental health experts, little has been done to improve the NIHB program. A joint review initiated by the Assembly of First Nations and the federal government in 2014 has seen little visible progress.
ISC spokesperson Maryeva Metellus said in an emailed statement that the department had increased staffing and training at its Ontario Region medical transportation call centre, simplified internal processes and streamlined travel request documentation.
"Call center performance and service levels are continually re-assessed to support improvements to client-focused service," she wrote.
The NIHB program represents a large-scale, government-administered benefits scheme whose operational failures illustrate the consequences when claims processing, communication infrastructure and service delivery fall out of alignment with the needs of the insured population - a lesson that carries relevance well beyond the public sector, the report said.
