Health Minister Mark Holland tabled a long-awaited bill Thursday meant to pave the way for national pharmacare and preserve a deal that secures NDP support for the government in the House of Commons. 

The bill also includes a program to cover birth control and diabetes drugs and supplies for anyone with a health card, which must now be negotiated with individual provinces and territories.

The government has not said how much it will cost to cover the initial list of drugs. 

The initial program was a condition of a bargain struck with the New Democrats, who touted the legislation Thursday as the fulfilment of a long-held dream. 

Pharmacare is a central pillar of the political pact between the two parties, which has the NDP helping the Liberals stave off an election in exchange for progress on a list of shared priorities.

Its future seemed uncertain earlier this month amid a months-long stalemate over the wording of the legislation and the number of drugs they planned to launch with.

The NDP announced they clinched the negotiations late last week, in the lead-up to a negotiated March 1 deadline to table a bill. 

“This is historic. This is the dream of our party since the conception of our party,” NDP Leader Jagmeet Singh said Thursday morning.

“It is happening not by coincidence, it is happening because New Democrats fought and we forced the government to do this.” 

Health critic Don Davies, who led the negotiations for the New Democrats, said the final pieces were put in place over the weekend.

“The NDP has been simply unceasing in our insistence that we build a system that constructs a single-payer formulary and a formula for pharmacare, and I can tell you that the legislation does that,” he said Wednesday.

The bill includes universal coverage as a binding principle that must guide the implementation of a future pharmacare program. 

The bill calls for the minister to put together a committee of experts to make recommendations about how to pay for a national, universal, single-payer plan within 30 days of the Act receiving royal assent. 

Conservative Leader Pierre Poilievre spoke to the media in the foyer of the House of Commons Thursday, but walked away when reporters asked him for his position on the government’s pharmacare plans. 

In December, the NDP and Liberals agreed to push back the original timeline, which would’ve seen legislation fully passed by the end of last year. 

The reticence on the Liberals’ part largely came down to cost. 

A full fledged pharmacare program would cost the government nearly $40 billion a year by the time it is fully up and running, the parliamentary budget officer estimates. 

Singh threatened to pull out of the parties’ political deal if the new March 1 deadline wasn’t met with legislation that earned his approval. 

But he and his party were open about their desire to keep the deal alive and see a pharmacare bill debated in the Commons. 

Alberta and Quebec have already said they want to opt out of the program and would rather put the money toward their existing drug plans. 

“We were not consulted about the federal government’s plan and, although information available to us is limited, we have concerns about the proposed limited scope,” Alberta Health Minister Adriana LaGrange said earlier this week. 

LaGrange said Alberta intends to opt out of the program, but still wants to receive its per-capita share.

On the other hand, British Columbia already covers many contraceptives as part of its provincial pharmacare program, and Manitoba’s government has already pledged to do so as well.

Ontario also provides many contraceptives for people under the age of 25 who don’t have private insurance, and has existing programs to support people with diabetes. The provincial government says it wants more information about what the bill will mean for those programs. 

“I was very clear with the minister when we spoke that I’m not writing off anything, but I’m also not buying into something where I don’t know exactly what’s there,” Ontario Health Minister Sylvia Jones said Thursday. 

If provinces were to opt out of the national plan, it could undermine some of the potential savings Canada would expect to see as a result of bulk drug purchasing, Davies said.

“New Zealand estimates they save 40 per cent on drug costs by having a single bulk-buying system. So, working toward having a much more effective, robust, national, comprehensive bulk-buying system would save us billions of dollars, it’s been estimated,” Davies said.

In addition to the initial list of drugs, the bill lays out several next steps and deadlines designed to nudge the government toward a bigger pharmacare plan.

Those steps include asking the new Canadian Drug Agency to develop a list of essential medicines within a year of royal assent, which would inform which drugs are covered in the future.