Social Policy in Ontario

It’s time for OHIP to cover all forms of prescription contraception

Posted on January 30, 2024 in Health Debates

Source: TVO.org — Authors: Chantal Braganza

TVO.org – Opinion/Affordability
Jan 29, 2024.   Written by Chantal Braganza

OPINION: The move makes sense financially. But it’s also simply the right thing to do.

Last March, Jennie Stevens, the NDP MPP for St. Catharines, tabled a motion in the legislature to open up OHIP coverage to all forms of prescription contraception. The timing seemed right: British Columbia was slated to become the first province to offer universal birth control, in April, and the Manitoba NDP made it part of their election campaign later that month. Seemingly every national organization invested in reproductive health, from the Canadian Paediatric Society to Action Canada to the Society of Obstetricians and Gynaecolgists, had been calling for similar policies for some time.

It was heartening to see Ontario’s Progressive Conservatives signal interest in supporting the motion in November, just a week after the newly elected Manitoba government had recommitted to its own promise.
As Ontario is looking at opening contraception prescription to midwives later this year, we’d be well-positioned to make access even easier.

So it was disappointing when, earlier this month, the government seemed to have a change of heart. “Our government already provides free, publicly funded contraceptives to nearly half of Ontario’s population through the Ontario Drug Benefit Program and OHIP,” a spokesperson for Health Minister Sylvia Jones told the Globe and Mail.

There are a few problems with this reasoning. For one, OHIP+ and the Ontario Drug Benefit’s coverage is limited to people under 25 who aren’t already covered by a private plan and to some recipients of Ontario Works and ODSP.

Who’s left out? Anyone older than 25 without a private health-care plan, temporary foreign workers in between contracts, people with refugee status, international students without private coverage, anyone in the three-month waiting period for OHIP approval, people without status or unable to prove their eligibility for OHIP, and those who are covered by a family plan but need to keep their contraceptive use private for safety reasons. In short: people with shifting economic and living realities and those for whom an unexpected or unwanted pregnancy would likely be especially destabilizing.

Second, publicly (and privately) insured contraceptive methods are limited. Patches, intrauterine devices, rings, and some newer oral contraceptives aren’t covered under OHIP+, which rules out those who require one of these options for secondary health reasons. Unlike over-the-counter painkillers, any given form of hormonal birth control isn’t unilaterally suitable for just anyone.

When people have to pay out of pocket for contraception — as up to 24 per cent of Canadians do — they can be left having not much of a choice at all. They may have to opt for a less appropriate contraceptive due to cost or forgo contraceptives entirely. When France introduced a free contraception plan for women under 25, in late 2022, it did so in response to declining use due to affordability.

Studies conducted federally and in places with differing health-care realities such as the United States and Uganda all show that providing barrier-free birth control reduces the public spending associated with unintended and/or unwanted pregnancies. This includes abortions, perinatal care, and any ongoing health care associated with poor birth outcomes, which are statisticallyassociated with unwanted pregnancies carried to term. OHIP covers this all, regardless of age or private-insurance status.

As Diane Peters reported for TVO Today last year, “B.C. will spend $119 million over three years; one conservative estimate, which dates back to 2010, says that the province could save $95 million in direct costs per year.” Given how widely B.C. residents have bought into the province’s program since it launched (almost 190,000 accessed it in the first eight months), it’s not unreasonable to expect the province will be able to prove this with data sooner rather than later.

Simply put, the money argument is sound. But it should not be the sole consideration. The onus of birth control overwhelmingly falls on the person who would become pregnant — despite the fact that contraception benefits anyone in that person’s life who would also be affected by an unintended pregnancy. Universal birth control is one simple way to start to address this inequality. Control over one’s own fertility is inherently tied to human dignity. A money-saving, life-improving policy that supports this should be a no-brainer.

https://www.tvo.org/article/its-time-for-ohip-to-cover-all-forms-of-prescription-contraception?utm_source=TVO&utm_campaign=5619c4ee10-TVO-Today-Newsletter-MON_COPY_01&utm_medium=email&utm_term=0_eadf6a4c78-5619c4ee10-68105177

Tags: budget, Health, ideology, jurisdiction, participation, women

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