The Senate has passed pharmacare legislation that will see Ottawa now work to set up agreements with provinces and territories for the coverage of some diabetes medications and contraceptives.
The Liberal government was keen to see the bill passed especially because of growing speculation that a federal election could happen sooner than its scheduled date of October, 2025.
The legislation, known as Bill C-64, is the product of a now-defunct agreement between the governing Liberals and the New Democrats in which, the two parties agreed to work together in exchange for action on key priorities.
The passage of the legislation means Ottawa can soon begin what it envisions as the first stage in this process: negotiations with each province and territory on the coverage of some diabetes medications and contraceptives. The timeline on rollout will hinge on whether these deals are reached and under what terms.
Last month, the federal and B.C. governments reached a memorandum of understanding on how the program could work. The agreement would see the province’s existing contraceptive coverage expanded to include hormone replacement therapy to treat menopausal symptoms. Both governments said at the time that they intended to enter into formal negotiations if Bill C-64 receives royal assent. B.C. is currently in the midst of a provincial election campaign.
Health Minister Mark Holland wrote to a Senate committee studying the legislation last month to confirm that the government intends for the diabetes medications and contraceptives involved to be paid for and administered through a public plan.
In a letter to the chair of the Standing Senate Committee on Social Affairs, Science and Technology, Mr. Holland wrote that as a first phase, Ottawa plans to negotiate bilateral agreements with provinces and territories to provide “universal, single-payer, first-dollar coverage” for a range of contraceptive and diabetes medications.
Mr. Holland’s outreach took place after concerns were raised about the legislation by pharmacare proponents. There were also calls for the bill to be amended for the sake of clarity, including by academics and a former health minister.
In the letter, Mr. Holland said the standard of coverage would see residents of a participating province or territory be eligible to receive free access, without co-pay or deductible, to a range of contraceptive and diabetes medications.
Mr. Holland said no one would lose coverage for these classes of medications and that the program would be delivered universally so that all residents would be covered by pharmacare.
In June, Mr. Holland said it was his goal that drugs would flow in provinces and territories by April of 2025.
The federal budget tabled in April, however, showed that the Liberals expect the majority of the spending in the pharmacare program to roll out in 2026, rather than 2025.
The federal budget allotted $121-million for the program next year. In 2026-27, that ramps up to $358-million, followed by $477-million for each of the two subsequent years.
The legislation stipulates that the federal minister must, no later than 30 days after the bill receives royal assent, establish a committee of experts to make recommendations on options for the operation and financing of “national, universal, single-payer pharmacare.”
NDP health critic Peter Julian said each year, there are Canadians who are are forced to go without prescriptions because they cannot afford them and individuals who die preventable deaths because they can’t access medications.
He said the NDP used its agreement with the Liberals to bring Canadians a step closer to universal pharmacare access.
The federal Conservatives do not support the legislation.
Bea Bruske, the president of the Canadian Labour Congress, said in a statement on Thursday that the passage of the bill is a “monumental win” and is a step forward toward universal, single-payer pharmacare.
Doug Roth, the chief executive of the Heart & Stroke Foundation, called Thursday’s vote historic and said it was also a “vote of hope for the millions of uninsured people in Canada.”
Christina Warner, the executive director of the Council of Canadians, a non-profit organization advocating for universal pharmacare, said people across the country are now counting on provincial leaders “not to play politics with their health and to make public, universal pharmacare a reality.”
Kathy Megyery with the Canadian Chamber of Commerce said her organization was disappointed about the bill being passed without amendments. The government didn’t clearly communicate its intentions to Canadians, she said, which prevented informed study and debate.