Health advocates call on Liberals to keep pharmacare promise ahead of budget

OTTAWA — Health care advocates say they’re worried the Liberal government will backtrack on its promise to create a universal, single-payer pharmacare program.

Frédérique Chabot, executive director of Action Canada for Sexual Health and Rights, said conversations with government officials lead her to believe Ottawa is “seriously considering” a different approach that would instead provide coverage to people without private insurance.

“A fill-the-gap approach is not a good investment for Canadians, and it’s not a solution that will actually improve health outcomes in the way that real universal, single-payer pharmacare will do,” she said.

A 2019 expert panel recommended the creation of a universal, single-payer program that would see the federal government cover the cost of medications through the medicare system.

The C.D. Howe Institute think tank released a report of its own last week calling on Ottawa to consider paring back the program to a mixed model, similar to the one in Quebec, that would provide government coverage for people without private insurance.

The report said such a model would be a more feasible option for a government whose fiscal priorities have shifted.

The Office of the Parliamentary Budget Officer projected in 2023 that a full universal, single-payer program would cost around $39 billion in 2027-28 — an estimated $13.4 billion more than the cost to the federal government under the current system for drug payments and other funding.

Chabot was one of several advocates who held a press conference on Parliament Hill on Monday — the same day they launched an ad campaign targeted at elected officials pushing for action on pharmacare.

Jason MacLean, chair of the Canadian Health Coalition, said Prime Minister Mark Carney and his government have been sending mixed messages on the file since the April election.

“We were sidetracked with the ‘elbows up’ and everything that’s going on with tariffs,” he said, adding that pharmacare was promised by “the majority of the Liberal MPs that are there right now.”

The Pharmacare Act was passed last October by the minority Liberal government as part of its supply-and-confidence agreement with the NDP.

Its first phase called on Ottawa to negotiate with provinces and territories to cover the cost of birth control and some diabetes medications.

Pharmacare deals have been struck with B.C., Manitoba, P.E.I. and the Yukon, but further talks stalled with the launch of the election campaign in the spring. Those four agreements account for more than 60 per cent of the $1.5 billion set aside for pharmacare in the last budget.

The re-elected Liberals have pledged to pour billions of dollars into national defence and launch a review of other government spending as Canada deals with the impact of a trade war with the United States.

Health Minister Marjorie Michel and Carney’s office declined to commit to signing more pharmacare deals over the summer, and committed only to protecting what was in place.

Earlier this month, the prime minister told reporters at a press conference in Edmonton that the remaining deals will be signed “as quickly and equitably as possible.”

“Mixed messages only create confusion and mistrust. Canadians deserve clarity on what is being negotiated and what it means for them,” MacLean said.

The law requires the national drug agency to develop a list of essential drugs for a national formulary and to work on a national bulk-purchasing strategy to bring prices down.

Olivier Surprenant, an analyst with the Quebec-based Coalition solidarité santé, said Quebec’s drug insurance program is increasingly expensive and the mixed model creates inequities for patients.

He also said U.S. President Donald Trump’s threats of pharmaceutical tariffs make it all the more important for provinces and territories to work together to purchase medications.

The Pharmacare Act also called for the creation of an expert committee to study the best way to create a universal program. That committee is set to report to Michel by Oct. 10, and the report is to be made public.

MacLean said the Canadian Health Coalition wants to see action on the file in the upcoming federal budget, and he urged the government not to “cave to corporate pressure” from the pharmaceutical and insurance industries, which he called “bad actors in this debate, putting profits ahead of people.”

This report by The Canadian Press was first published Sept. 22, 2025.