Calgary·Analysis

Free contraception — the intended consequences of Alberta NDP's new promise

Rachel Notley's team was so keen to follow B.C. NDP's new birth control policy that they rushed it out in time for International Women's Day. And the spring election.

Followed B.C.'s new plan in time for International Women's Day. And the election

Alberta NDP Leader Rachel Notley interlaces her fingers as she speaks at a Calgary event, in purple light and in front of Calgary Chamber of Commerce banners.
Alberta NDP Leader Rachel Notley pledged that prescription contraception would be free for all Albertans if her party forms the government after the May 29 election. (Jeff McIntosh/The Canadian Press)

I learned today, and not in the four decades of my life prior, that most birth control pills cost $20 a month, or $240 a year. I also learned that an intrauterine device (IUD) can run $500.

I didn't know these things because I'm a man.

I already knew — through experience last fall — that vasectomies are a publicly insured health care service, but had given it little thought. Same reason as above.

Guys may not think about these costs much or at all, but their female sexual partners, sisters, daughters and female colleagues surely have had to.

WATCH | Premier Danielle Smith's response to the Alberta NDP's contraception proposal: 

Opposition MLAs ask Alberta premier why she won't adopt their free contraception plan

2 years ago
Duration 3:13
Premier Danielle Smith downplayed the need for the opposition party's free prescription contraception plan, saying people seeking birth control have many options already.

Well, this dude was prompted to think about this anew when the Alberta NDP on Wednesday promised to make various forms of prescription contraception free if they're elected this spring. It's an idea directly taken from the British Columbia government's budget last week, which makes it the first Canadian province to universally cover contraception.

If NDP Leader Rachel Notley returns as premier, her promise would cover an array of contraceptives, including pills, injections, IUDs, and the "Plan B" morning-after pill. 

She said it will not only save Albertans money, but by helping prevent unintended pregnancies it ensures women will have more control over their lives and economic futures.

"It's good health policy, good economic policy and it's the right thing to do," Notley said at her announcement.

Reproducing a promise

A proposal by any party a few months from an election, in opposition or government, will inevitably exist at the intersection of politics and policy.

Notley's team appears so enthused by the prospects of both that they raced to parrot the free contraception plan from their B.C. NDP counterparts in time for International Women's Day. Notley made a point of announcing it while standing in front of her 10 fellow female New Democrat MLAs. It's a message aimed broadly at women, and particularly designed to enthuse the young women that MLA Janis Irwin says have been asking for this on the heels of B.C.'s announcement, which dropped the same day as Alberta's budget.

While this is new territory in Canada, universal access to contraception is a reality in the United Kingdom, Australia, New Zealand and many European countries.

A significant number of Alberta women are already protected from the out-of-pocket costs of birth control, thanks to private insurance programs and some limited provincial coverage for young people unable to afford birth control.

How many are left out? With the hasty release of this pitch, Irwin said the NDP hasn't come up with this figure.

However, it is clear the risks of unintended pregnancy are higher among lower-income people: a University of British Columbia study has shown that young women with lower household incomes are less likely to use oral contraceptives, or any at all. And almost any Canadian woman who's used birth control might be aware that the most effective prescription contraceptive — IUDs — are also the costliest.

Demonstration of how to insert an intrauterine device (IUD) into a uterus model.
An educator from Planned Parenthood holds up an intrauterine device (IUD). They are considered 99 per cent effective at stopping pregnancies; better than pills, injections or condoms. But they're also far costlier, commonly $500 in Alberta. (Matthew Howard/CBC)

The NDP was able to come up with a cost estimate for making contraception free, directly adapted from the B.C. plan: $30 million per year. That amounts to less than 0.05 per cent of Alberta's $68.3-billion overall budget, or one per cent of the extra spending Premier Danielle Smith's government added this year.

It's the sort of pledge the NDP was proud enough of to ask in Question Period: why aren't you doing this too, Premier Smith? Though she allowed a "certain number of women" lack access to coverage, the premier replied that with all the various insurance policies and public support, the opposition's commitment is largely redundant.

"I'm not sure why the members opposite are wanting to give a subsidy to private insurance companies, because the vast majority of prescription drugs are covered under private plans," Smith retorted in the legislature.

One of Smith's own promises would take costs off Alberta supplementary health insurers' backs, too, in a more expansive and expensive way. She has promised to give every Albertan a $300 health spending account for uninsured services, many of which are covered in private plans — though Smith wasn't able to have the idea ready for this spring's budget.

A political device

Though it wasn't part of the NDP's public messaging Wednesday, progressive parties often use reproductive rights or policies as wedge issues against conservatives. The United Conservative Party certainly had a socially conservative wing, for whom former premier Jason Kenney's promise "not to legislate of social issues" was also a quiet reassurance that a UCP government wouldn't do anything to expand abortion or other reproductive services. 

Smith is avowedly pro-choice and socially libertarian, but she also has a caucus and coalition to maintain. And while these issues sharply divide conservatives, the broader Alberta public consistently favours abortion and reproductive rights. It's likely this remains a policy contrast between the two parties duking it out for the swing voters in suburban Calgary and other swing areas.

In polls, the NDP already enjoys a solid lead over the UCP among Alberta women, perhaps second only to the edge Notley's party enjoys in Edmonton.

But there's a key difference between these figures. No matter how high the NDP can run up its vote share in the capital, there are only 20 seats and the party already controls 19 of them. But women? They're in all 87 ridings, and ideas that resonate with them can reap benefits everywhere.

And the B.C. government may have started a trend that sweeps across Canada. In Conservative-led Ontario, the health minister said she's "looking closely" at the idea as well.

Surely, there will be a debate about the costs or wisdom of expanding universal coverage to contraceptives. On social media, that seemed to come mostly from men — who, like me, haven't ever had to worry themselves about what the pill or another solution costs, but perennially benefited from the prevention they offered.

ABOUT THE AUTHOR

Jason Markusoff

Producer and writer

Jason Markusoff analyzes what's happening — and what isn't happening, but probably should be — in Calgary, Alberta and sometimes farther afield. He's written in Alberta for more than two decades, previously reporting for Maclean's magazine, Calgary Herald and Edmonton Journal. He appears regularly on Power and Politics' Power Panel and various other CBC current affairs shows. Reach him at jason.markusoff@cbc.ca