In April 2023, B.C. became the first province in Canada to cover the cost of prescription contraceptives for all ages.Rich Pedroncelli/The Associated Press
Zoe Lazaris has had brain injuries and suffers from migraines, which used to leave her bedridden for days. But then she discovered that taking hormonal birth controls pills worked wonders to reduce her headaches.
“It’s improved my quality of life a lot. I don’t have to stay at home for a full day as often as I used to, when I was just taken out by a migraine,” the 22-year-old recent university graduate said.
As a student, the cost of her pills was significantly reduced. She’s now got a job filling in on a maternity leave contract, and doesn’t know what her future career – or drug plan – will look like.
In Ontario, dozens of prescription contraceptives are covered by the Ontario Health Insurance Plan until age 24. But advocates say there is a gap after that, if people don’t have private insurance, or if they are on family plans but wish to use contraceptives without the knowledge of their spouse or parents.
“In my future, the coverage is going to look different depending on the jobs I get,” Ms. Lazaris said.
In April, British Columbia became the first province in Canada to cover the cost of prescription contraceptives for all ages, including birth control pills, hormone-injections and the intrauterine device (IUD), which can cost up to $500. Manitoba, under new NDP Premier Wab Kinew, has pledged to do the same.
In Ontario, the Official Opposition NDP this fall pushed the Progressive Conservative government to consider backing a similar plan, through a motion that called on OHIP to cover prescription contraception for all. But the government didn’t support it, saying it already has programs that cover free prescriptions for youth under 24, and other initiatives such as the Trillium Drug Program, which helps people with high prescription drug costs compared with household incomes.
“Our government already provides free, publicly funded contraceptives to nearly half of Ontario’s population through the Ontario Drug Benefit program and OHIP+,” said Hannah Jensen, a spokeswoman for Ontario Health Minister Sylvia Jones.
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But proponents also say it’s about accessibility: making prescriptions free and easy to obtain, no questions asked.
Mohini Datta-Ray, executive director of Planned Parenthood Toronto, which serves youth aged 13 to 29, says many of the centre’s clients don’t have access to OHIP, are past 24 years of age, don’t want to tell their parents they are using contraception or have parents without insurance.
Since the pandemic, she said the centre has seen a four-fold increase in youth who are not insured.
“What we’re seeing, unfortunately, is they don’t have access to contraceptive coverage, and so then sometimes abortion itself becomes a form of birth control,” Ms. Datta-Ray said.
“It’s a much more involved process then just having access to an IUD or birth control pills.”
She said many people also need contraceptives to address other health concerns such as endometriosis, a disease of the uterus that causes extreme pain, or cancers.
NDP Leader Marit Stiles said expanding the scope of free contraception is beneficial to society as a whole. “This saves money in the long run on the health care system and in social services,” she said.
Her party’s motion targeted “people who fall through the gap” after age 24, when OHIP+ expires. “I think we need to broaden it out and realize that people’s reproductive life is a lot longer than that,” Ms. Stiles said.
In British Columbia, residents can get prescriptions for contraception from doctors or nurses at walk-in clinics and hospitals, as well as directly from pharmacists. BC PharmaCare, the province’s publicly funded program, covers the cost of more than 60 commonly used birth control methods. The government has pledged more than $119-million over the next three years for the program, and estimates it saves $95-million annually.
According to the B.C. government, between April 1 and Nov. 28, 2023, more than 188,000 people received free contraceptives. This includes more than 123,000 people who received hormonal pill contraceptives, more than 30,000 people who received IUDs, and more than 37,000 people who obtained emergency contraceptives.
Adrian Dix, B.C.’s Health Minister, said the measure improves women’s health outcomes as well as addresses affordability concerns. He said while some plans covered costs previously, they also came with a significant deductible, which cost people money.
“All of this is good news in terms of access to health care, quality of health care and making life more affordable for women. So I think it’s a change whose time has come, and I would strongly recommend other jurisdictions follow what B.C. has done,” he said in an interview.
Manitoba has also said it will provide universal coverage for women’s contraceptives in 2024. Manitoba Health Minister and Deputy Premier Uzoma Asagwara said in an interview the government is working through the details of the plan. “We want to make sure that doctors have the ability to prescribe what it is in the best interest of their patient’s health, not just what their patients can afford.”
For Ms. Lazaris, finding medication to treat her condition has been life-changing.
“If I don’t take my birth control for the day, I have a migraine and then I’ll be in my bed all day, like I can’t leave my room. It’s vital health care,” she said.
“For that to be something that people have to worry about – it’s not ok.”