Bill 2 will reduce women’s access to health care, two associations warn

Contraception, abortion, cervical cancer screening, pregnancy care and gynecological exams are among the women’s health services left in the blind spot of Bill 2, two Quebec medical associations warned Thursday.

The Association des omnipraticiens en périnatalité du Québec (AOPQ) and the Association des obstétriciens et gynécologues du Québec (AOGQ) say they fear for patients if the law is not corrected.

They say the issue lies on two levels. First, most women’s health services fall under the “green” category, meaning patients are considered healthy.

Second, clinics will not be recognized as meeting performance targets if they treat patients assigned to other physician groups, which is often the case for pregnancy followups.

The government wants family doctors to prioritize patients with major conditions, listed as “red” cases.

A key measure in Bill 2 ties physician compensation more closely to capitation, a system in which doctors are paid more for having red-category patients on their roster.

Dr. Angie Brockman, a family physician and president of the AOPQ, says contraception care illustrates the gaps in the law. Depending on the calculation, she says a doctor would receive between $3 and $17 for inserting an IUD.

“It’s going to be a losing practice,” Brockman said. “It’s a procedure that can be uncomfortable; you have to support the patient and respect her time. It’s the same for the contraceptive implant, Nexplanon, which is often used by younger women. You have to do local anesthesia. Sometimes they get dizzy, they have a drop in blood pressure. It’s not something you can rush.”

She says 80 per cent of her patients are not registered with the clinic where she works, most do not have a doctor, or their doctor does not provide pregnancy care.

“All these patients, when it comes to capitation, are worth nothing,” Brockman said. “As of April 1, 2026, they’re worth nothing to me and nothing to my clinic because they’re green-category patients, but even more, most of them aren’t registered in my family medicine group. I’m not their doctor forever; I’m their doctor for this episode of care.”

Brockman says there is an urgent need to act, particularly for pregnant patients.

“The patients I saw this week or will see next week are giving birth in July,” she said. “The government tells us, ‘We’ll explain later.’ But right now, in Bill 2, pregnant women and pregnancies are nowhere.”

She says the Fédération des médecins omnipraticiens du Québec (FMOQ) has confirmed there are currently no exceptions planned, no discussions underway, and no provisions specific to pregnancy care in Bill 2.

Gynecologists already at capacity

The AOGQ shares the concern, even if the measures affect specialists differently. In Quebec, patients cannot see a gynecologist for routine screening or basic contraception; specialists handle complex cases.

“Sometimes we have years-long waits for problems that require our expertise,” said Dr. Liliane Brassard, vice-president of the AOGQ. “If we’re also expected to compensate for gaps in primary care, it won’t work. We simply don’t have the capacity to see the women who truly need specialized care.”

Brassard questions what will happen to pregnant women at clinics that focus exclusively on pregnancy followups. Some may be forced to close. “That could mean women won’t have access to appropriate pregnancy care, which would be a disaster in Quebec,” she said.

She cites the World Health Organization, which recommends a minimum of eight prenatal visits to reduce the risk of death for pregnant women, infants and newborns.

Brassard says she is giving Health Minister Christian Dubé “the benefit of the doubt” for not considering nuances in women’s health care.

“Mr. Dubé didn’t write this law alone,” she said. “It seems like certain specialized women’s health practices were forgotten. It needs to be reviewed; it needs to be corrected.”

Everyone pulling in their own direction

Last week, the Quebec government and the FMOQ agreed to resume negotiations. The government says it is open to amendments but intends to keep part of family doctors’ compensation tied to caring for more Quebecers.

That does little to reassure the president of the AOPQ.

“Dr. Amyot (the FMOQ president) is doing his best. We’re 10,000 family doctors, and I’m trying to defend a small group of 400,” Brockman said. “Everyone is pulling the blanket to their side, but I’m really afraid we’ll fall through the cracks, that our concerns won’t carry enough weight because it’s a small niche. I fear it won’t be a priority for the government, and unfortunately, probably not a priority for my federation in the middle of all this upheaval.”

She urges Minister Dubé to amend Bill 2 to preserve fee-for-service payments or enhance compensation for specialized services such as pregnancy care, contraception and abortion.

– This report by La Presse Canadienne was translated by CityNews