Mental Health and Addictions Services Covered

Summary#

This bill adds mental health, addictions, and substance use health services to the list of “insured health services” under the Canada Health Act. It also amends the “comprehensiveness” rule so provincial plans must cover these services, including those delivered in community settings, to meet federal standards (Bill, s.2; amended s.9).

• Expands the definition of insured services to include mental, addictions, and substance use health services (Bill, s.2).
• Clarifies that services provided in community settings are included, not only in hospitals (Bill, s.2).
• Updates the comprehensiveness criterion so provincial plans must insure these services, including those by other health practitioners where provincial law allows (amended s.9).
• Provinces that do not meet the criteria risk deductions from federal health transfers under the Canada Health Act (Canada Health Act).
• The bill does not provide new funding or set specific timelines; it changes definitions and compliance requirements. Data unavailable.

What it means for you#

• Households

  • Public coverage could expand to more counseling, therapy, and addiction treatment delivered outside hospitals once provinces update their plans to comply (Bill, s.2; amended s.9).
  • If these services become insured in your province, user fees and extra-billing for them would be restricted under the Act’s rules for insured services (Canada Health Act, ss.18-21).
  • Timing depends on provincial implementation. The bill sets no phase-in dates; it takes effect on Royal Assent.

• People seeking mental health or addiction care

  • More services in community clinics, outpatient programs, and similar settings may be covered under the provincial plan to meet the amended comprehensiveness requirement (Bill, s.2; amended s.9).
  • Coverage details (which services, by which providers) will still depend on each province’s laws and schedules. The amendment requires coverage “where the law of the province so permits” for services by non-physician practitioners (amended s.9).

• Health workers and clinics

  • Non-physician providers authorized by provincial law (e.g., where applicable, psychologists or other practitioners) could become eligible to deliver insured services and bill the public plan, subject to provincial rules (amended s.9).
  • Clinics offering community-based mental health and addictions services may need to meet provincial billing, reporting, and quality requirements to receive public payment.

• Employers and private insurers

  • If provinces expand public coverage, some services now paid by workplace benefits could shift to the public plan over time. Immediate effects are uncertain and depend on provincial policy. Data unavailable.

• Provincial/territorial governments and health authorities

  • Must ensure their plans insure mental, addictions, and substance use health services, including in community settings, to satisfy the comprehensiveness criterion (amended s.9).
  • Non-compliance with the Act’s criteria can trigger federal deductions from health transfers; extra-billing or user charges for insured services can trigger automatic deductions (Canada Health Act; ss.18-21).

Expenses#

Estimated net cost: Data unavailable.

• The bill changes definitions and compliance criteria but does not appropriate funds or set transfer amounts. Data unavailable.
• Provinces may need to expand publicly insured services and adjust fee schedules to comply; the scale and cost depend on current coverage in each province. Data unavailable.
• Federal fiscal impact would occur through administration and any deductions or adjustments to transfers if provinces are non-compliant; amounts would vary by enforcement and provincial responses. Data unavailable.

Proponents' View#

• Creates parity between mental health and physical health by making mental, addictions, and substance use services insured under the Act’s core definition (Bill, s.2).
• Expands access by clearly including services delivered in community settings, not just hospitals, which is where many patients receive care (Bill, s.2).
• Strengthens national minimum standards: provincial plans must insure these services to meet the comprehensiveness criterion and keep full federal health transfers (amended s.9; Canada Health Act).
• Reduces financial barriers because insured services are subject to the Act’s prohibitions on extra-billing and user charges, improving affordability for patients (Canada Health Act, ss.18-21).
• Supports team-based care by allowing coverage of services provided by other regulated health practitioners where provincial law permits, aligning payment with how mental health care is often delivered (amended s.9).

Opponents' View#

• Imposes new obligations on provinces without dedicated funding in the bill, creating potential budget pressures or trade-offs with other services. Data unavailable.
• Uses broad terms (“mental, addictions and substance use health services,” “community settings”) that may be contested, leading to disputes over what must be insured and administrative burden to define scope (Bill, s.2; amended s.9).
• Risks Canada Health Transfer deductions if provinces cannot meet the expanded comprehensiveness criterion quickly, which could destabilize provincial planning (Canada Health Act).
• May strain the workforce: expanding insured coverage without added clinicians could lengthen wait times or displace existing services. Data unavailable.
• Could disrupt private benefit markets and provider payment models, requiring complex provincial changes to fee schedules and billing systems with uncertain timelines and costs. Data unavailable.