Eliminating out-of-country health insurance could jeopardize access to necessary medical care and become a hardship for some travellers, the federal health minister warned Wednesday in a letter to her Ontario counterpart.

Ginette Petitpas Taylor said the move announced by Premier Doug Ford's Progressive Conservative government will hurt people whotravel regularly to the United States.

"If all publicly financed reimbursement of out-of-country physician and hospital services is eliminated, private health

insurance premiums for travellers will inevitably rise for all Ontario residents," Petitpas Taylor said in her letter to Ontario Health Minister Christine Elliott. "Even modest increases could pose a hardship for some individuals."

The program currently covers out-of-country inpatient services up to $400 per day for a higher level of care, such as intensive care, as well up to $50 per day for emergency outpatient and doctor services.

In May, Elliott announced the decision to scrap the program following a six-day public consultation, saying it is very costly and does not provide value to taxpayers.

The change is expected to come into effect Oct. 1.

Province intends to wind down program

A spokesman for Elliott confirmed Wednesday that the government intends to wind down the program and strongly encourage people to purchase travel health insurance.

"The program's coverage is very limited with only five cents of every dollar claimed," Travis Kann said in a statement. "With this limited coverage and low reimbursement rate, OHIP-eligible Ontarians who do not purchase private travel health insurance can be left with catastrophically large bills to pay."

Elliott has said the province spends $2.8 million to administer approximately $9 million in claim payments through the program every year.

On Wednesday, Petitpas Taylor stressed that if Ontario moves ahead with its plan it will be the first jurisdiction in the country to provide no coverage for emergency hospital and physician services received out of country.

The minister said this would be "inconsistent" with the Canada Health Act, which stipulates that all Canadians are entitled to continuing coverage of their provincial health plans when they are temporarily absent from home.

"Ontario's approach will mean that Ontario residents will have to cover the costs of care out of pocket, should they require medical attention while travelling," she said.

Opposition says move will hurt frequent travellers

Opposition politicians have said ending the program will hurt frequent travellers. In April, NDP health critic France Gelinas wrote Petitpas Taylor and asked her to intervene and stop Ontario from eliminating the coverage.

"I am urging you to follow through on the prime minister's commitment ... where he affirmed the federal government's responsibility to ensure provinces follow the requirements of the Canada Health Act," she said.

The Canadian Snowbird Association has urged the government not to make the move and said it would not only impact seniors who travel south during the winter months, but also cross-border shoppers and anyone planning a family vacation.

In her 2018 report, auditor general Bonnie Lysyk said the Ministry of Health processed an average of 88,000 out-of-country claims per year over a five year period and paid an average of $127 per claim.

Lysyk also noted the high administrative costs of the program, but said they arise because staff must check varying physician services fee rates and process claims manually. She recommended that the government seek ways to reduce administrative costs by adopting a single reimbursement rate for all health services obtained out-of-country.

She also recommended the government bolster efforts to inform Ontarians of the limit on reimbursement rates under the program and on the need to purchase private health insurance before travelling.