The Pharmacare Act, Bill C-64, received Royal Assent on October 10, 2024. It is the first step to providing national universal pharmacare starting with free coverage for diabetes medications, devices and supplies, as well as contraceptives.
The Act also requires that Canada’s Drug Agency develop a list of essential drugs and related products that will help with the development of a national bulk purchasing strategy to help further reduce drug prices. The agency will also develop a pan-Canadian strategy on the appropriate use of prescription medications.
The governments of BC, Manitoba, PEI and the Yukon signed bilateral agreements. BC signed on March 6, 2025 and is receiving over $670 million in federal funding over four years.
Manitoba signed on February 27, 2025 and is netting over $219 million over four years.
The “Improving Affordable Access to Prescription Drugs Program” that PEI signed in March 2022, provides $35 million in federal funding over four years and allowed for the addition of 61 new medications to the provincial list in 2023 that included treatments for cancer and heart disease.
As of April 15, 2026, the Yukon National Pharmacare Program has been receiving federal funding of $9.5 million spread over four years.
Despite the act going into effect immediately, Ontario’s provincial government has not signed onto the initiative. Instead, the Doug Ford government made the political decision to leave hundreds of millions of federal dollars on the table — funding that would have benefitted Ontarians during the ongoing affordability crisis.
Robbin Lennox, Ontario NDP Shadow Minister for Mental Health and Addictions with responsibility for Primary Care, introduced a motion calling on the Ontario government to expand the Ontario Drug Benefit and implement universal prescription medication coverage for all Ontarians on May 25, 2025
“Right now, too many people in Ontario are making impossible choices—between filling a prescription or paying rent, buying groceries or taking medication,” Lennox told rabble.ca during an interview. “Universal pharmacare is a practical, compassionate solution that would save lives and reduce costs across our entire healthcare system.”
Lennox is a family physician and the NDP MPP for Hamilton Centre. Her work with St. Joseph’s Hospital, Hamilton Social Medicine Response Team (HAMSMaRT) and the Shelter Health Network, means Lennox has provided frontline care to the unhoused community that also addresses the overdose crisis. Lennox previously served on the city’s Public Health Sub-Committee making recommendations to Hamilton Council on emerging issues.
Having access to necessary medications improves quality of life and longevity
Lennox cited the fact that one-in-five Ontarians don’t have access to public or private prescription coverage in a province that boasts one of the highest drug deductibles.
One-in-ten people have admitted that they can’t take a prescribed medication because of cost. Under the Trillium Drug Program, residents must pay four per cent of their household income before any coverage begins. During a cost-of-living crisis that four per cent an unmanageable threshold for many families. That means people resort to rationing and forgoing treatment putting their health at imminent risk.
Eliminating out-of-pocket costs for essential prescription medications exerts a range of positive impacts on Ontario’s over burdened healthcare system including keeping people out of emergency rooms and hospitals; preventing disease progression; and reducing preventable deaths. Research has overwhelmingly proven that expanding access to prescription medications is cost-effective and allows freed up dollars to be reallocated within the healthcare system.
Workers benefit from universal federal pharmacare
Ontario provides prescription drug coverage for people under the age of 26 and over the age of 65; those living in long-term care facilities; as well as those living on Ontario Disability Support Program (ODSP) or Ontario Works (OW) who qualify for drug benefit coverage.
Additionally, people in hospital receive medications free of charge, but only until they are discharged at which time they assume that cost. That cost may prove prohibitive and expecting someone relying on a prescribed medication for pain relief or recovery is counterintuitive to the premise of universal healthcare.
Millions of working Ontarians also find themselves shouldering the full cost of essential medications. When that cost becomes financially unfeasible, that can lead to skipped doses, delayed care, preventable health crises and even death.
The Workplace Safety and Insurance Board (WSIB) only covers medications that directly apply to injuries experienced on the job. Yet, Ontario workers injured on the job often experience long term physical and emotional effects.
The lack of access to medications needed to treat the tertiary effects of being injured on the job directly impacts trades people and their families further compounding their ability to survive on workers compensation payments.
Given the current gig and short-term contract economy that’s dominating the Ontario workscape, Lennox believes all Ontarians deserve unconditional access to all necessary prescription drugs.
Your boss should not determine your access to healthcare
“Your boss shouldn’t determine your access to healthcare. And, for many, many people between the ages of 26 and 65, their access to medication benefits and extended health benefits depends on their ability to maintain their employment,” Lennox explained.
When it comes to workers, not enough attention has been paid to the fact that employer health benefits can trap folks in inappropriate jobs. Workers with family members relying on certain prescription medications may not be able to leave jobs that are toxic or underutilize their skills simply because they can’t afford the out-of-pocket cost of medications for family members that are covered by their current employer’s healthcare plan.
Universal pharmacare has the added benefit of enabling unions to bargain for better wage increases and working conditions rather than forgoing those in order to secure improved healthcare plans for members. This improves workers rights while strengthening bargaining powers.
Housing is healthcare
Research has proven that when the social determinants of health are not met, tax payers pay a much higher cost downstream in the form of increased healthcare, policing and overall societal costs.
Lennox believes in evidence-based medicine driven by science. She has studied cost-benefit analysis that overwhelmingly shows investing in peoples’ health saves money.
“We would save far more money than what we have to put in because people aren’t arriving in hospital in emergency departments because of preventable complications of illness. It improves peoples’ quality of life. It improves their ability to participate in the workforce which makes us have a healthier economy. And, the evidence is unquestionable,” Lennox said.
Adding, “And, yet, there’s a barrier to getting it implemented because of politics, because of political priorities.”
Lennox observes that the Ford government is more influenced by private interests and lobbyists – particularly those representing private drug insurers in Canada and Ontario – with a vested interest in maintaining private drug plans.
She also points to the Ford government’s thin grasp of exactly which upstream interventions prevent downstream costs highlighting the inability to see that building non-market housing would in fact help with the healthcare crisis.
“Housing is healthcare because we know that housing status, particularly being unhoused on average shortens your life expectancy upwards of 30 years,” Lennox pointed out.
For Hamilton that means someone living unhoused has a life expectancy of living into their late 40’s compared with an average life expectancy of housed individuals living into their late 80’s.
Ensuring access to affordable housing that costs a maximum 30 per cent of a renter’s gross income; having access to culturally appropriate and affordable foods; as well as access to medically required prescription medications means that society actually pays less in the long run.
The Ford government continually ignores the social determinants of health. That government has eradicated rent caps, failed to prioritize affordable housing, and now is sidelining fully funded universal prescription medication and healthcare in favour of American style, profit driven healthcare that will inevitably bankrupt Ontarians.
Consider for a moment that a healthy American family of four pays $25,000 US annually just to be able to access a family physician through private insurance plans and it becomes clear why private healthcare is neither desirable, feasible nor sustainable.
Lennox’s short-term goal is to get the Ford government to sign onto the pharmacare agreement for universal access to diabetes and contraceptive coverage.
