In November, NWT Health Minister Glen Abernethy said the territory would cover the abortion pill (branded as Mifegymiso in Canada) for residents who do not have any other form of health insurance.
FOXY (Fostering Open eXpression among Youth), the Midwives Association of the Northwest Territories, Northern Options for Women and Action Canada for Sexual Health and Rights wrote an open letter to the Premier asking him to go even further and provide universal cost-coverage for the abortion pill, and give healthcare providers other than physicians, such as midwives and nurse practitioners, the authority to prescribe it.
Some might say that partial coverage is better than no coverage. But we know from evidence across other provinces and territories that without universal cost-coverage, people can’t access the services they need and are entitled to.
In the case of the abortion pill, it means some people don’t claim the drug under their private insurance fearing disclosure to family members because they are covered through a spouse or parent. It means that some people who have private insurance may only be covered partially or not at all.
Private insurance often means dealing with co-pays, deductibles, paying upfront and filling out complicated paperwork only to be reimbursed later. This creates undue financial and administrative stress to many, especially when the abortion pill costs anywhere from $350 to $450.
We also know that the abortion pill is time sensitive, accessible only within the first nine weeks of pregnancy in Canada. There is often no time to navigate insurance claims that can delay and ultimately jeopardize access to this necessary medical procedure.
Alongside universal cost-coverage and in an effort to reduce delays, the government needs to allow midwives and other healthcare providers to prescribe the abortion pill – in addition to physicians.
This is crucial in Canada’s north where residents sparingly have access to a doctor. Northern Options for Women is a program that provides abortion services to people in the NWT. Their mission is to provide accessible, non-judgmental, evidenced-based abortion care. With more support from the government and the expanding ability of midwives and nurse practitioners to prescribe the abortion pill they could support increased access to abortion services and care in the NWT.
We know what the harmful impact of barriers to abortion, such as cost, look like. Barriers increase the number of unsafe abortions and the burden placed on those who are forced to travel long distances to access care. This disproportionately impacts young people, low-income earners and those living in rural and remote communities.
To address these issues, the NWT government must implement universal cost-coverage for the abortion pill and expand prescribing authority of the drug. Together, this will meaningfully begin to dismantle unjust barriers that prevent access to this medically necessary service.
If the NWT government provides universal cost-coverage to the abortion pill – just as nine other provinces and territories in Canada already have – it would reduce health inequities and improve accessibility, especially for people in rural and remote communities. It would also reduce the overall health care costs for abortion procedures, given the travel required to regional hospitals as well as hospital time for patients undergoing an abortion.
If healthcare truly is universal, access to abortion shouldn’t depend on your postal code.
Beyond equal access to health, increasing access to abortion care is a gender equality issue, and a human rights issue.
Universal cost-coverage of the abortion pill, and allowing midwives and nurse practitioners to prescribe the pill, has the potential to greatly advance reproductive rights in the NWT. When reproductive rights are secured, people are best placed to decide if, when and how many children to have, to have families in supportive environments, to exercise their right to health and bodily autonomy, to live empowered lives.
Governments in British Columbia, Alberta, Ontario, Quebec, New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland and Labrador, and soon in the Yukon, have implemented universal cost-coverage programs to ensure their residents have access to the abortion pill – so why not in the NWT?
Candice Lys holds a PhD in Public Health, is co-founder/executive director of FOXY/SMASH and lives in Yellowknife. Sandeep Prasad is executive director of Action Canada for Sexual Health and Rights in Ottawa.