N.W.T. health minister says she won't pause changes to health benefits regime

The N.W.T.'s health minister says she won't pause the rollout of changes to the territory's extended health benefits program, after a standing committee of MLAs urged her to do so.

Lesa Semmler was not available for an interview and sent CBC a written statement.

The program helps cover the cost of prescription drugs, medical supplies and equipment that aren't eligible for coverage through third-party insurers.

Two significant changes include an income assessment to determine eligibility for the program and doing away with the current specified disease conditions list. The list includes about 50 conditions that currently guarantee coverage under the program.

Semmler said about 2,200 N.W.T. residents currently do not have access to the benefits that the program will provide.

Committee wants a cost-benefit analysis

"Leaving those 2,200 residents – many of whom are low-income – to go without extended health benefit coverage is not something I'm prepared to do," Semmler wrote.

"It is unfortunate and disheartening that the people who need these benefits the most, and who this new policy is designed to help, seem to have been forgotten in much of this discussion."

In a letter to Semmler, dated June 3, committee chair Jane Weyallon Armstrong wrote that the committee has yet to see a full cost-benefit analysis of the changes — or the costs of alternative options, such as expanding the program to cover all N.W.T. residents without introducing income testing.

The changes would establish a low-income threshold, and residents who are over that threshold need to pay a portion of their costs out of pocket; they're also not eligible for dental or vision coverage.

Semmler said income thresholds will be set at the ministerial level, and "will allow for consistent review and flexibility."

She also said the policy update means the N.W.T. will be more aligned with jurisdictions across Canada and can access federal programs like the Canadian Dental Care Plan and national pharmacare.

"These informed revisions have been carefully planned and will be phased in over time," Semmler wrote. "They are key to ensuring that public funds are achieving positive impacts to the greatest possible extent, and to ensuring that no resident of the N.W.T. is excluded from the coverage they need."

The changes are set to take effect Sept. 1.