Two weeks ago, without a public announcement, Manitoba added the abortion medication, Mifegymiso, to their provincial drug formulary. Unlike Alberta, New Brunswick, Quebec and Ontario, where universal cost coverage will be offered for anyone with a provincial health card, Manitoba will only cover those with extended drug benefits through “Manitoba Pharmacare.”
Manitoba is reinforcing and sustaining a system of two-tier access to abortion, and gaps remain.
The pill will also be covered by the province in one or two, possibly three clinics, that already offer surgical abortion. While this will expand options available within these clinics, the move will not address the most common barriers to access in Manitoba.
The province is one of the most difficult in which to access abortion. Many seeking the service are required to travel upwards of 20 hours to the two southern cities where it is offered: Winnipeg and Brandon, or leave the province altogether. Mifegymiso’s $350-$450 price tag is only one of the many costs associated with access. Travel, accommodation, child or family care cost and lost wages make it difficult for many to access abortion services that are limited to urban centres. People need access to abortion services within their own community or as close as possible. Universal cost coverage is one step closer to achieving this.
Formularies are not a substitute for universal cost coverage. Under Manitoba’s program, a 30-year-old single woman with no dependents and a salary of $45,000 per year would have to reach a $2,400 deductible before the medication would be covered – a cost most people won’t reach. Manitoba’s drug benefits also fail to cover those who have not signed up for the program in advance.
While the “Manitoba Pharmacare” program offers some compensation, this program is intended for those whose income would be most severely impacted by high prescription drug costs. It does not always match the diverse needs of someone seeking an abortion. Complicated and patchwork programs fail to meet the needs of all people.
Everyone in Canada deserves equal access to healthcare. Alberta, New Brunswick, Ontario and Quebec have already demonstrated that universal cost coverage is both necessary and possible. It’s time Manitoba and the rest of Canada follow their lead.