Is pharmacare on ice? Health minister says no new deals with provinces in the works

Canada’s public pharmacare programme appears to be in limbo, with the federal soldier wellness government minister confirming capital of canada isn't in talks with the remaining provinces and territories to reach deals.

This month's budget also did not include additional money to expand coverage nationwide — leaving advocates questioning the future of the public drug plan.

More than a year ago, the Trudeau Liberals passed the Canada Pharmacare Act. In it, the federal government committed to signing agreements with all provinces and territories to cover the cost of contraceptive and diabetes medications and devices.

Seen as the first step to bring in nationwide, universal drug insurance for Canadians, four provinces and territories — B.C., Manitoba, P.E.I. And Yukon — signed deals with Ottawa before the federal election.

“For now, we have the four provinces with this coverage,” Michel said.

“I'm continuing conversation with provinces and territories on next steps. So not for today, but I'm still continuing conversations."

But are those conversations happening in earnest?

Federal budget doesn’t include new money for pharmacare expansion

Ontario’s Ministry of Health did not provide a response. Saskatchewan and New Brunswick both said they were ready to speak with Ottawa. Quebec and Alberta said they were waiting to hear back from the federal government.

Alberta also said it has “serious concerns” about the program’s long-term sustainability. That province has told Ottawa it wants to decide what medications are covered.

Health minister on expanding pharmacare: 'For now, we have the 4 provinces'

When asked repeatedly about the nature of negotiations with the remaining provinces, Michel pointed to some of them wanting different medications covered.

“When the pharmacare agreement happened last time, some provinces or territories didn't want to have the two coverages that we offered at that time. And it's still true,” Michel said.

“We are there to support our partners. And I'm having conversation with them on how we can best support them for now.”

But other provinces appear ready to sign agreements with Ottawa under the original framework. Nova Scotia said five months ago it wanted to restart talks.

Pharmacare advocates point to this fall’s budget as another signal the government may be slow-rolling its commitment.

In over 400 pages, the budget only mentions pharmacare once, when the Liberals say they are “protecting the vital social programs Canadians rely on, from child care to dental care to pharmacare.”

Prime Minister Mark Carney has used the word “protecting” for some time, seemingly a promise to keep existing deals but not pursue more.

“There are certain demands or desires to expand in different areas, and we won't be able to move as quickly as we otherwise would,” Carney said last month.

But the prime minister’s messaging on pharmacare has been mixed. In September, he told reporters that Ottawa was committed to signing the remaining agreements.

If that’s the case, Carney hasn’t earmarked enough cash to make that happen.

His new budget sets aside no additional money to cover the cost of drugs for future deals.

Sixty per cent of the $1.5 billion set aside in 2024 to pay for the medication is already spoken for by the four provinces and territories with existing agreements.

“That’s worrying,” said Teale Phelps Bondaroff with AccessBC, a grassroots group that successfully lobbied for free contraceptives in British Columbia and has advocated for access across the country.

“If the federal government wants to negotiate with large jurisdictions like Quebec and Ontario, they're going to need to bring more money to the table. And we didn't see that in this budget,” he said.

Phelps Bondaroff said the current four pharmacare deals only cover about 17 per cent of the population.

"There's now a huge disparity in Canadians' ability to access life-saving and life-changing medicine. And that's fundamentally unacceptable,” he said.

According to the federal government, one in five Canadians have little to no private drug insurance and must pay out of pocket for their medication. 

A 2024 Leger poll commissioned by the Canadian Cancer Society and the Heart & Stroke Foundation found one in four Canadians surveyed had to choose between paying for prescription medication and cutting back on groceries, rent, house payments, bills or incurring debt.

It's concerning for diabetics like Roger Cook, a New Brunswick man who pays hundreds of dollars a month for his medication and has been waiting to see his province join the national plan.

“People shouldn’t have to go without food to buy medicine, or go without medicine to buy their food. It should be there for them,” he said. “It’s very alarming.”

The lack of clarity from the federal government is also alarming to the federal NDP.

The pharmacare legislation was the result of the confidence-and-supply agreement between the previous Trudeau Liberals and the opposition New Democrats. The NDP agreed to support the Liberal minority government on key votes for more than two years in return for social programs like dental and pharmacare.

"Everyone feels like they're kicking the can down the road,” said the NDP’s health critic Gord Johns.

"We've asked the minister repeatedly and they say they're committed to pharmacare, but there's still no action on any new deals. It's been months that they've had opportunities to sign new agreements,” Johns said.

He said the lack of money in the budget shows the Liberals aren’t truly committed to pharmacare.

“It's not nation-building when you only give certain provinces access.”

Journalist

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