Bill C-64

Pharmacare Act

An Act respecting pharmacare

This enactment sets out the principles that the Minister of Health is to consider when working towards the implementation of national universal pharmacare and obliges the Minister to make payments, in certain circumstances, in relation to the coverage of certain prescription drugs and related products. It also sets out certain powers and obligations of the Minister — including in relation to the preparation of a list to inform the development of a national formulary and in relation to the development of a national bulk purchasing strategy — and requires the Minister to publish a pan-Canadian strategy regarding the appropriate use of prescription drugs and related products. Finally, it provides for the establishment of a committee of experts to make certain recommendations.

[Glenn Thibeault, Executive Director, Government Affairs, Advocacy and Policy, Diabetes Canada]

Thank you, Chair.

Through you, I want to thank the committee for inviting me to testify today.

For the more than four million people living with diabetes in Canada, access to affordable medications and devices is critical. In fact, the out-of-pocket costs of things like medications, devices and supplies can be as high as $18,000 per year if individuals are solely reliant on public coverage. I will, therefore, focus my remarks on two areas: the implementation and funding provided for diabetes medications under Canada's new national pharmacare program, and the need for investments to support the national diabetes device access fund.

As we know, earlier this month, Bill C-64 received royal assent, creating the framework for a national pharmacare program, which is a good first step. However, many of Diabetes Canada's concerns remain unresolved. During the parliamentary debate on Bill C-64, Diabetes Canada emphasized that the best approach to establishing a national pharmacare program would be to initially focus on helping people who lack adequate coverage for their prescribed treatment regimes and to ensure there are no disruptions to their private coverage. We recommended the inclusion of a provision very similar to the dental care legislation to clarify that a federal pharmacare program will not jeopardize the current system. We remain concerned about the potential unintended consequences of the legislation.

We have also raised concerns with the current draft formulary for diabetes medications, as they do not align with Diabetes Canada's clinical practice guidelines, also called CPGs, which are developed to inform general patterns of care and public policy. Diabetes is a complex condition that has a constantly expanding list of new therapies and medications, and those medications and therapies should be available and covered as options of care.

Within the legislation that has passed, the Minister of Health is now required to direct Canada's Drug Agency to compile a list of essential medicines that will inform the national formulary. As such, Diabetes Canada continues to call for an immediate expansion and update of the background formulary to reflect the CPGs so that people living with diabetes can access the medications they need to support their best possible health outcomes.

We are also calling for an increase to the baseline funding to ensure that the program meets the needs of persons living in Canada with diabetes. If the program is truly a single-payer universal system, then the initial budget 2024 allocation of $1.5 billion over five years, which covers both diabetes and contraception medications, will not provide a sufficient basis of funding for this program to operate properly.

Let me explain: The estimated yearly cost of diabetes medications, as assessed by the private health insurance industry, is over $1.6 billion per year, and in 2023, public spending on diabetes medications was $1.8 billion, which is close to $3.5 billion per year just for diabetes medications alone.

Beyond pharmacare, I also want to speak about the importance of establishing a national diabetes device fund, which the government committed to last February. One-quarter of the people living with diabetes have reported that the additional cost of diabetes devices affects their adherence to their prescribed treatment regimes, which has significant risks to their short- and long-term health. Over the past few years, Diabetes Canada has worked with many provinces and territories to expand affordable access to diabetes devices. We are proud of this work to increase access and are keen to see further expansion of these programs.

However, since last February, we have seen what I would describe as stasis as provinces and territories await further details from the federal government about the device access program before further expanding their programs. That is why it's critical that the government urgently provide more details on its intentions with respect to a federal device and equipment access program as quickly as possible.

Personally, as someone who lives with type 2 diabetes, I know how dramatically my device has improved my quality of life and ability to manage and control my diabetes effectively. The use of devices and equipment that helps individuals manage their diabetes also contributes to a broader savings in the health care system. We also believe further savings could be seen across the country if there is further action undertaken to implement the federal framework for diabetes in Canada.

In closing, by providing that common policy direction through the framework for multisectoral stakeholders, as well as provincial and territorial governments, we can identify gaps in current approaches, avoid duplicating efforts and provide opportunities for monitoring and reporting on progress. Those six framework components would not only improve the quality of life for those four million people in Canada living with diabetes, but save the system dollars.

Therefore, I look forward to working with members of this committee to ensure that the upcoming budget reflects these realities for people living with diabetes in Canada.

I look forward to your questions.

Thank you, Chair.

Pharmacare Act

[Sherry Romanado, Liberal, Longueuil—Charles-LeMoyne, QC]

Mr. Speaker, on October 10, An Act respecting pharmacare received royal assent. Among other things, this act will provide Canadian women with universal single-payer coverage for various contraceptives. Nine million women and gender-diverse people will benefit from that.

Over the past few months, many women in my riding of Longueuil—Charles-LeMoyne have told me how important this act is for them. Canadian women want to be able to choose if, when and how they start a family. Our government listened to them. Unfortunately, the Conservatives voted against this act every step of the way.

We know the cost of contraceptives is one of the many barriers to gender equity in Canada. Our government will always stand up for a woman's right to choose and make medical decisions about her own body. Our Pharmacare Act delivers on that commitment.

Pharmacare

[Brendan Hanley, Liberal, Yukon, YT]

Mr. Speaker, yesterday was a momentous day for Canadian health care. Bill C-64, the Pharmacare Act, received royal assent. This landmark legislation will establish a framework for national, publicly funded, single-payer universal drug coverage; it will ensure that Canadians across the country have access to the diabetes medications and contraception they need.

Can the Parliamentary Secretary to the Minister of Health share with the House what passing this landmark pharmacare legislation will mean for the health of Canadians?

[The Deputy Speaker, Conservative, Chris d'Entremont]

I have the honour to inform the House that a communication has been received as follows:

Rideau Hall

Ottawa

October 10, 2024

Mr. Speaker,

I have the honour to inform you that the Right Honourable Mary May Simon, Governor General of Canada, signified royal assent by written declaration to the bills listed in the Schedule to this letter on the 10th day of October, 2024, at 6:26 p.m.

Yours sincerely,

Secretary to the Governor General,

Ken MacKillop

The schedule indicates the bills assented to were Bill S‑205, An Act to amend the Criminal Code and to make consequential amendments to another Act (interim release and domestic violence recognizance orders)—Chapter 22; Bill C‑291, An Act to amend the Criminal Code and to make consequential amendments to other Acts (child sexual abuse and exploitation material)—Chapter 23; and Bill C‑64, An Act respecting pharmacare—Chapter 24.

Message from the Senate

[The Deputy Speaker, Conservative, Chris d'Entremont]

I have the honour to inform the House that a message has been received from the Senate informing the House that the Senate has passed the following bill: Bill C-64, An Act respecting pharmacare.

[Nancy Hamzawi, Executive Vice-President, Public Health Agency of Canada]

Back in October 2022, the framework for diabetes in Canada was released, marking a major milestone to better support Canadians. Through budget 2021, the government committed $20 million to research through the Juvenile Diabetes Research Foundation and the Canadian Institutes of Health Research partnership to defeat diabetes, including $15 million matched by the JDRF.

Since February 29, you all have been having discussions on Bill C-64 around national universal pharmacare, with diabetes being a very important pillar to that bill.

Thank you very much.

Pharmacare Act

[Adam van Koeverden, Liberal, Milton, ON]

Thank you, Madam Speaker. There is not only heckling but also unnecessary interruption.

I will use my remaining time to talk about diabetes and those living with diabetes. Diabetes is a disease with no cure. There is a treatment, and it is thanks to Canadian science, which is something that our government supports. Canadian scientist Frederick Banting and his team came up with an interim solution, I suppose we could call it; it is a treatment for diabetes that allows diabetics to live. Without it, diabetics would not have the opportunity to live fulfilling lives, but we still need to fight for a cure. Before we get there, we should also ensure that we reduce inequality and inequities in the populations impacted by diabetes.

There is a really interesting infographic from the Public Health Agency of Canada. Anybody who is watching this debate might be interested in how diabetes and inequality intersect in Canada. I was actually very surprised to learn that diabetes and employment status are related; there is a positive correlation between them. When people are employed, they are less likely to suffer from diabetes and live with diabetes. When people are permanently unable to work, they are more likely to have diabetes, which means that they naturally have a lower income. It is the same for education level, surprisingly. Almost 10% of those individuals with less than a high school education will have diabetes or prediabetes throughout their life; for university graduates, that goes down to between 3.5% and 6.1%. There is also a positive relationship within income quintiles. All five income quintiles are associated with a positive relationship. As income goes up, people are less likely to have diabetes. Therefore, providing folks living with diabetes with free access to medication, to insulin and to supports for managing their illness is also an affordability measure that would make a difference for a lot of Canadians.

Diabetes also affects people disproportionately in different categories. There are complex social and environmental behavioural factors that result in inequalities in the burden of diabetes between certain populations in Canada. The prevalence of diabetes is 2.3% higher among South Asian Canadians, and it is 2.1% higher among Black adults.

For indigenous adults, the prevalence of diabetes is similarly staggering, at 1.9% higher for first nations Canadians living off reserve. Inequities experienced by first nations, Inuit and Métis populations are a direct result of colonial policies and practices that included massive forced relocation, loss of lands, creation of the reserve system, banning of indigenous languages and cultural practices, and the creation of the harmful residential school system. Unaddressed intergenerational trauma adds to the ongoing challenges faced by indigenous peoples, and providing them with a reliable and affordable treatment for diabetes would support affordability.

This would also reduce the number of times people with diabetes have to access health care as a result of their illness. People with diabetes are more at risk of all sorts of life-changing health crises, such as a heart attack or stroke, kidney failure, blindness and amputation. At this very moment, there are about 3.7 million Canadians, or 9.4% of our population, who have been diagnosed and have to manage their condition for their entire life. If members can believe it, in 2015, 25% of Canadians with diabetes indicated that they followed their treatments to a T, but they were affected by cost; in some cases, those Canadians were rationing medications to save money. Therefore, a quarter of the people who are following their treatments are affected by cost. There are other Canadians who are undiagnosed, and there are Canadians who are not following their treatments. We need to make sure that they live a healthy and fulfilled life, and one way to do that is to ensure that they have access to this vital medication.

About one out of three people is living with diabetes or prediabetes today in Canada, and rates of diabetes are ever rising. It is estimated that, by 2028, over 13 million Canadians, or 32% of the population, will have diabetes or prediabetes. Through Bill C-64 and the work of the national framework for diabetes, we can improve aspects of preventative care as well. We can do this through information sharing and knowledge transfer, while also ensuring that those living with diabetes have access to insulin and other diabetes medications.

This is a cost-saving endeavour. The Conservatives have continually referred to this as a spending program, as if it would not be invested directly in the health of Canadians. Not only would it be invested in their long-term health outcomes, but it would also be invested directly in their affordability. It would support affordability, and, as I pointed out, that is something that is positively correlated with other risk factors.

We introduced the national framework for diabetes in 2022 to align multisectoral efforts to reduce the impact of diabetes in Canada. The framework comprises about six interdependent and interconnected components that represent the range of areas where opportunities to advance efforts on diabetes could and will be beneficial.

Bill C-64 would support people living with diabetes, whether through improving access to the medications they need or giving them the tools they need to have a better quality of life in Canada. We are here for Canadians. Our plan to provide universal coverage for contraception and diabetes medications would be transformative, and I still have faith that the Conservatives will see the light and recognize that this is a very popular and worthwhile endeavour.

We should all get behind national pharmacare for Canadians.

[Adam van Koeverden, Liberal, Parliamentary Secretary to the Minister of Environment and Climate Change and to the Minister of Sport and Physical Activity]

Madam Speaker, it is an honour to rise this evening to discuss the bill before us, Bill C-64, an act respecting pharmacare. We can all agree, or I hope we can all agree, that Canadians should have access to the right medicines at an affordable price regardless of where they live in our country. That is precisely what Bill C-64 would do. It represents the first phase toward a national pharmacare plan, starting with the provision of universal single-payer coverage for contraception and diabetes medications. This legislation is an important step forward to improve health equity, affordability and outcomes and has the potential of long-term savings to the health care system and for all Canadians who use it.

In budget 2024, we announced $1.5 billion over five years to support the launch of national pharmacare and coverage for contraception and diabetes medications. The single most important barrier to access to contraception in Canada is cost. For example, the typical cost for select contraceptives in our country for an uninsured Canadian woman is up to $25 per unit, or $300 per year, for oral birth control pills and up to $500 per unit for a hormonal IUD, which is effective for five years.

It occurs to me that if oil and gas companies were going to start selling diabetes medications, insulin or contraceptives, the Conservatives might be all for it. It seems like they are the only group, the only organization, and the only affordability measures the Conservatives can come up with are supports for oil and gas.

However, Canadians have lots of expenses, and one of the main expenses associated with inequality and inequities in our society is their medications. We are here to help. Some populations are disproportionately affected by the lack of coverage. Women, people with low incomes and young people, all of whom are more likely to work in part-time or contract positions and thereby not have access to a drug plan, often lack access to private coverage. One study found that women from lower-income households are more likely to use less effective contraceptive methods or no contraceptive method at all as a result of their lower-income situation.

Bill C-64 would ensure that Canadians have access to a comprehensive suite of options when it comes to contraceptive drugs and devices, because improved access to contraception improves equality. This means that every woman in Canada would have the ability to choose the contraceptive that is best for her, regardless of her ability to pay. This would contribute to her right to have bodily autonomy, which is what this government fully supports.

Sexual and reproductive health is a priority for this government. This is reflected in Bill C-64, as I have mentioned, but it goes beyond that in other significant federal initiatives. Our government is committed to improving the sexual and reproductive health outcomes for all Canadians, and this includes helping to ensure access to a comprehensive suite of contraceptive drugs and devices for everyone. By working with provinces and territories and guided by the principles within Bill C-64, we can make this a reality.

The proposed Bill C-64 lays the groundwork for that process, and through it, with collaboration with provinces and territories, we are helping to fight for affordability for all Canadians. By passing this legislation, collectively, we can all continue to build on the momentum we have already achieved.

I looked into this. Pharmacare in Canada is deeply popular with people who vote for all parties. It is almost 90%, in fact. This is something I expect all members of Parliament to get behind. It is something a lot of Canadians support, regardless of party.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, I believe there is at least one province, possibly even more, that has acted on the issue of contraceptives. We will find, as I said, that there are different policies in different provinces, and so forth.

What is really important to recognize is that Bill C-64 would help an estimated nine million people in dealing with contraceptives. When we think about diabetes medications, we are talking about over 3.5 million people. That is a lot of good reasons to get behind this legislation and ensure there are some standards across the nation.

The House resumed consideration of the motion that Bill C-64, An Act respecting pharmacare, be read the third time and passed.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, I will be splitting my time with the member for Milton.

I want to address what I would suggest is the ultimate potential assault on health care by the Conservative-Reform Party of Canada. For the record, to be very clear, one needs to look at what the member for Abbotsford said today, which has been repeated in many different ways by different members. I have often talked about the hidden Conservative-Reform agenda.

I personally see health care as an important issue going into the next federal election, and my intention is to point out the contrast. When I say that the Conservative Party has crazy policies, we should think about them saying that the federal government has no constitutional role. One would think they were separatists, like the Bloc. They believe the federal government should just be an ATM machine, hand over the cash and say nothing about health care because the federal government has no role to play. Both the Conservatives and the Bloc believe that there is no role for the federal government to play in health care.

Then, they say that it is a constitutional God-given right that provinces are the only ones that have anything to do with health care. That is absolutely wrong. I would ask members to cite a Supreme Court of Canada decision that says that the Canada Health Act is in violation of the Constitution. I would like members to tell me which premier or which province took the government to the Supreme Court and had a favourable ruling on that issue. The simple answer is that it has not happened. That is why the Conservative spin of misinformation continues to flow, and that is most unfortunate.

Unlike the Conservative Party, Liberals understand and value the important role that the federal government in Ottawa plays. In terms of the pharmacare program, it is interesting to hear from different opposition members, the Conservatives and the Bloc, as they have that unholy alliance on Bill C-64 for different reasons. We have well over 100 policies on pharmacare, depending on what province people are in or which company they work for. There are many different types of policies facing the pharmacare issue.

The idea of a national pharmacare program is nothing new. The Prime Minister is moving the issue forward. That is what Bill C-64 is all about. It recognizes there is a need for the national government to work, where it can, with provinces, to develop a national pharmacare program that has similarities in all regions of the country. The way I see it, there are two areas where we are focusing a great deal of attention today. I see it as a step forward. I believe that provinces will continue to look at what is being proposed and will come on board.

The arguments I hear from the Conservative Party today are the types of arguments one would have heard generations ago regarding health care when public health was brought in. Those are the types of arguments of deniers. I suspect we will never hear the Conservative Party saying they are going to get rid of the Canada Health Act. Maybe a good opposition day motion would be what people have to say about the Canada Health Act and whether they support it or not.

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Madam Speaker, I do like the little cute condescension from the NDP: “when he reads the bill”. The bill, Bill C-64, is four pages. I did read the bill. It is really cute when they have that passive-aggressive tone. It is adorable.

If they sign on and if they do take the universal single-payer coverage, what are his constituents going to say when their coverage is less than what they had before?

What is he going to say to 27 million Canadians who are losing better coverage because they are going to add coverage that is not as good as what they have right now? They would have a lot of explaining to do to their constituents when they try to take away the coverage they have right now and give them less coverage.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Madam Speaker, the member for Regina—Lewvan was quite adamant that health care delivery is the purview of the provinces. I think that when he reads the bill, Bill C-64, he will be delighted to find that, in the pharmacare proposal that we are debating today, the delivery of pharmacare is delivered by the provinces.

The other thing I think he will be quite delighted with is the fact that provinces will have the ability to sign on or not to sign on with the pharmacare plan that is being debated. I think the only challenge he is going to have is that, when the Province of Manitoba and the Province of British Columbia sign on and when their residents start receiving free contraception and free diabetes medication and devices, the residents of his province, his constituents, are going to start asking why they are not able to tap into the benefits of universal pharmacare.

I would just ask him what he is going to say to them in those situations.

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Madam Speaker, it is pleasure to rise to speak to Bill C-64 for a second time. I spoke at second reading of this bill on Thursday evening, and I am happy to speak to third reading of the pharmacare pamphlet.

I would like to repeat some of my remarks made during my speech at second reading. I have asked, time and time again, for any of the NDP-Liberal costly coalition members to tell me how many provincial ministers asked for a pharmacare bill at a federal-provincial-territorial meeting. Not one of the Liberal ministers, Liberal members or NDP members actually answered me. Quite frankly, they did not want to say out loud that the answer is zero. This was not at the top of a wish list for any of the provincial health ministers.

I have been talking with our health minister in Saskatchewan. He still has no details about what this pharmacare pamphlet would look like or how it would affect the people of Saskatchewan. The biggest fear at the provincial level is that coverage would lessen in Saskatchewan. They have done a good job of building health care back up in Saskatchewan after the nineties, when the NDP ruined health care in Saskatchewan, which I will get to later in my speech. The provincial health ministers are asking, “Where are the details?”

We have talked about how the federal Liberal government continues to bring in bills without any consultation. We have seen it in agriculture, in oil and gas, and even with the budget. At the agriculture committee on Thursday, I asked the agriculture minister about who he consulted in the ag sector when it came to increasing the capital gains tax exemption from a half to two-thirds. I have not gotten a straight answer from a lot of the Liberal ministers at committee, but to that minister's credit, he said that he did not even know that it was in the budget. A senior minister in the government did not know what was going to be in budget 2024.

I have had the honour of serving in the Government of Saskatchewan, and I know there is quite a process to get a budget approved. It goes through Treasury Board finalization, then through cabinet finalization, then through caucus finalization, and then back to cabinet for a final sign-off.

My colleague, the member for Abbotsford, who gave a great speech, was in government, and I think he probably saw most of what was going to be in the budget before it came out. When a senior minister who has been here for a long time, some might say too long of a time, admitted that senior ranking Liberals did not see the budget before it came out, I was dumbfounded. It was unbelievable.

It does not surprise me, then, that this bill was brought forward with very little consultation with anyone. We all know this was signed off on, on the back of a napkin, to placate the junior NDP partners, so they would prop up the corrupt government for years, or at least until the member for Burnaby South gets his pension. We know what this is about, and it is to ensure that the NDP-Liberal costly coalition stays in power. This is the price Canadians are going to pay.

Right now, 27 million Canadians are anxious about losing some of the health coverage they have right now as they have health coverage that they want to keep. I will admit that 1.1 million Canadians are under-insured or do not have insurance. Why does the government not focus on that? We could have had something rolled out that supplemented the provincial government programs. Instead, the costly Liberal coalition government always wants to be the one that rides in on the white horse, saying, “We are going to save you. We have a national plan.”

We have a national day care plan. A friend of mine is now number 300 on the wait-list in Regina, which is not that big of a city. The government has made day care spots less available in my city of Regina, Saskatchewan.

The federal government has a dental plan that no dentist wants to sign off on. I have a letter from the Saskatchewan Dental Hygienists' Association, where 99% of dental assistants and dental hygienists are female, and there was not one consultation with any of those stakeholder groups about what they should do or if they thought the dental care plan was a good idea. Once again, there was no consultation. This is a recurring theme.

We have a national lunch program for which the Liberals did not do any consultations with any school boards. In Regina, there are a lot of great corporate citizens who donate a lot of money to lunch programs. When we got together as a group and talked about this, I asked if anyone knew how many lunch programs were in our city. The Regina Food Bank covers some programs. Mosaic Market covers some programs. Nutrien covers some programs. If we put all those programs together, we could do a lot of good and almost get to where we need to so all kids could have food when they go to school.

There was no consultation on that either. The Liberals just come in on their white horses and think they are saviours. It is almost like someone over there has a God complex, one might say. They always want to be the one walking in and saving people, but they do not work with anyone else across the country.

Let us get to the pharmacare program. Once again, it is a pharmacare program, with no consultation, that no one asked for at a provincial level. My friend for Winnipeg North talked about how health care is not within provincial jurisdiction, but it is. Health care delivery is within provincial jurisdiction. He knows that, as he is a former MLA. Money transfers come from the federal government, but the day-to-day operational delivery of health care is one hundred per cent a provincial jurisdiction. He knows that.

It is interesting for the Liberals to bring in a national program, or a pamphlet, really, that covers two things, and then act like they are the conquering heroes. Who asked for this at a provincial level? I hope my friend from Winnipeg North will ask me a couple questions about that.

There is one more thing when it comes to health care in our country. The biggest threat to health care in Canada is whenever there is a provincial NDP government. The NDP in Saskatchewan devastated health care. When it was in government, it closed 52 hospitals in my province. It closed 1,200 long-term care beds in Saskatchewan during the nineties. It fired 1,000 nurses, hundreds of doctors, and rural Saskatchewan was divided.

The NDP is the pioneer of our two-tiered health care systems. In Saskatchewan, there is much different health care if someone is in rural Saskatchewan compared to urban Saskatchewan. The NDP went so far as to close the Plains Health Centre hospital in Regina. It was one of the best hospitals in the city and was the newest hospital. The NDP closed it because it was servicing too many rural Saskatchewanians. It was unbelievable.

We now have a government in B.C., an NDP provincial government, that is pioneering a pharmacare program, but it has it backward. It is giving B.C. residents free drugs that are killing them, instead of having a plan in place to give residents affordable drugs that would be life-saving. That is what B.C. is doing right now.

Instead of putting money toward life-saving drugs, the Liberals want a safe supply, which I do not think exists. They continue to spend taxpayers' dollars in British Columbia to give drugs to people who are killing themselves with those drugs. That is so opposite to what a government should be doing. The Liberals want to come in like they are champions of pharmacare. They should talk to some of their B.C. cousins about what is going on in that province. They should take some of the money they are spending putting illicit hard drugs on the street, and maybe supplement that with some programs that would give drugs to people that would help save their lives instead of end their lives.

I would end with one more conversation about how consultation is so disregarded by the government. Obviously, the NDP are going to vote for this terrible piece of legislation. The Liberals will vote for it.

One thing I would say to members is to please consult with the health ministers of the provincial governments because Saskatchewan is doing a great job. It has diabetes coverage for everyone up to age 25. We have a $25 cap on senior drugs, a program that helps seniors make sure they get the medication they need.

Provinces are in charge of the delivery of the health care system. Please let them keep that in their domain, and do the proper thing and consult with the health ministers in this country.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Madam Speaker, I was just saying how important contraceptives are to nearly nine million women in this beautiful country we live in, nearly one-quarter of the Canadian population.

Contraception, also known as birth control, is used to prevent pregnancy, whether it is required for family planning, medical treatment or overall reproductive health. Improved access to contraception improves equality, reduces the risk of unintended pregnancies and improves reproductive rights.

The single most important barrier to accessing contraception in Canada is cost. For example, the typical cost for select contraceptives for an uninsured Canadian woman is up to $25 per unit, or $300 per year, for oral birth control pills, and up to $500 per unit for a hormonal IUD, which is effective for five years.

Some populations are disproportionately affected by the lack of coverage. Women, people with low incomes and young people, all of whom are more likely to work in part-time or contract positions, often lack access to private coverage. One study found that women from lower-income households are more likely to use less effective contraceptive methods or no contraceptive method at all. Although most drug plans list a range of contraceptive products, unfortunately only a fraction of Canadians are eligible for prescription birth control at low or no cost through a public drug plan.

Bill C-64 would ensure that Canadians have access to a comprehensive suite of contraceptive drugs and devices, because improved access to contraception improves health equality. This means that every woman would have the ability to choose a contraceptive that is best for her, regardless of her ability to pay. This would contribute to her right to have bodily autonomy, which is what this government fully and fundamentally supports.

In addition, ensuring access to a comprehensive suite of contraceptive drugs and devices at no cost to the patient can lead to savings for the health care system. British Columbia implemented this policy at the provincial level last April, and studies from the University of British Columbia suggest that no-cost contraception has the potential to save the B.C. health care system approximately $27 million per year. In the first eight months of that policy being in place, more than 188,000 women have received free contraceptives.

Sexual and reproductive health is a priority for this government. This is reflected in Bill C-64 but, as I have mentioned, it also goes beyond that to other significant federal initiatives. As part of budget 2021 and budget 2023, the Government of Canada has continued to demonstrate its commitment to improving access to sexual and reproductive health care support, information and services for Canadians who face the greatest barriers to access; and to generating knowledge about sexual and reproductive health for health care providers.

Since 2021, the sexual and reproductive health fund has committed $36.1 million to community organizations to help make access to abortion, gender-affirming care and other sexual and reproductive health care information and services more accessible for underserved populations. An additional $16.7 million has been provided to the Province of Quebec.

Budget 2023 renewed the sexual and reproductive health fund until 2026-27. This initiative has funded 21 projects and is currently funding 11. The sexual and reproductive health fund is providing $5.1 million to the University of British Columbia contraception and abortion research team for a 25-month project from March 17, 2023, to March 31, 2025, entitled the “Contraception and abortion research team access project, advancing access to abortion for under-served populations through tools for health professionals and people seeking care”.

As a segment of the project centres on contraception, the project has partnered with the Canadian Pharmacists Association to develop educational resources that support pharmacists prescribing contraception and assist pharmacists in understanding and tailoring their approach for indigenous and racialized populations, including youth and other underserved populations.

With the support of the University of Toronto youth wellness lab, the project will also engage with family planning professionals, for example pharmacists, family physicians, obstetricians, gynecologists, nurses, midwives and social workers, to optimally design affirming and judgment-free services and contraception information care by, with, and for youth. Additionally, the medical expense tax credit has been included to include more costs related to the use of reproductive technologies, making conception more affordable.

In conclusion, our government is committed to improving the sexual and reproductive health of all Canadians. This includes helping to ensure access to a comprehensive suite of contraceptive drugs and devices for all Canadians. By working with provinces and territories, and guided by the principles within Bill C-64, we can make this a reality.

As we move forward, Liberals will continue to work with the provinces and territories, indigenous peoples and other stakeholders to ensure we get this right. The proposed Bill C-64 lays the groundwork for that process and would guide our collaboration. By passing this legislation, we could continue to build on the momentum we have already achieved. We are well on our way and I look forward to working with all parliamentarians to realize the next phase of Canadian health care.

Whether it is dental care; the Canada child benefit; $10 day care and the national learning strategy; helping the almost 3.7 million individuals who have diabetes; or providing dental care for seniors, and now moving into another segment of the population, which I believe is individuals with disabilities, we are going to be there and have the backs of Canadians today and into the future.