Health Care Checkup: Pharmacare update – what you need to know

Health Care Checkup  

The Liberal government’s pharmacare legislation is a major step closer to becoming law. 

Introduced in late February, Bill C-64 passed in the House of Commons yesterday and now heads to the Senate for review. 

With only three weeks left in the legislative session, the legislation barrelled through Committee and votes in the House of Commons in record time (less than 10 days of debate and study). The Standing Committee on Health rejected the vast majority of the amendments and passed the bill with only minor changes.  

All Politics  

A little more than a year ahead of the next federal election, Bill C-64 is a critical component of the government’s supply-and-confidence agreement with the NDP. The agreement effectively allows the Liberals to act as a majority government, knowing they have NDP support so long as they address their agreed-upon priorities.  

Initially pledged to be passed by the end of 2023, the Liberals and NDP agreed to extend the deadline and introduce the legislation by March 1, 2024. Arguing that the Conservatives were delaying debate on Bill C-64, the Liberals used time allocation tactics to speed up debate allowing the legislation to move through the House of Commons at a rapid pace.  

By passing the legislation, the Liberal government wants to demonstrate tangible benefits to Canadians lacking access to key drugs. Meanwhile, the NDP is highlighting the policy as a key example of their ability as an opposition party to get results for Canadians. Both parties are increasingly looking to strike a contrast with the Conservatives, particularly around universal access to contraceptives and protecting women’s reproductive rights. The Conservatives opposed the bill, maintaining it offers “false hope” to Canadians by marketing universal pharmacare while covering only two types of treatments: birth control and diabetes drugs.  

Single-Payer? Not so fast 

The Liberals and the NDP have stated that the Bill C-64 is “framework legislation” that will guide a future universal and single-payer plan by providing free access to contraceptives and diabetes medications. However, the Parliamentary Budget Officer’s analysis concluded this was not the case. Instead, Canadians will have the option to continue to access these drugs through their existing plans or choose to participate in this new program – similar to what has been called a “fill-the-gaps” model, which looks to provide coverage only for those who are uninsured or underinsured. This critical detail was confirmed by Health Minister Mark Holland at Committee and during Third Reading debate. 

Some stakeholders, including the Conservatives, continue to express concern that the legislation does not clearly outline how this program will work and could possibly open the door for a national single-payer program in the future. 

What’s Next?  

After passing Third Reading, the legislation now moves on to the Senate for review.  

While there will certainly be political pressure for the Senate to pass this quickly, the Senate is also in the process of reviewing legislation related to the 2023 Fall Economic Statement and the 2024 Budget. The exact timing remains uncertain, but it’s anticipated that Bill C-64 will be passed before the Senate rises in late June or early fall.  

Minister Holland has signalled his desire to begin negotiating with the provinces and territories as soon as possible once the legislation receives Royal Assent, with the goal of announcing agreements prior to the federal election. In addition, a Committee of Experts is likely to be struck at that time to provide recommendations on how pharmacare will be operated and financed.   

Safe to say, passage of the legislation is just the tip of the iceberg. Many details, including how the program will be funded, what drugs will be included and when Canadians will be able to access contraceptives and diabetes medications, will be made more clear in the months ahead. 

Stay tuned to EnterpriseHealth for the latest as Canada’s national pharmacare saga continues to move along!