Thank you, Mr. Chair. So it's the department's opinion effectively that this budget would be going up if not for the changes that were made? Nodding heads is good enough for me, Mr. Chair. And I'm out of my time. So thank you.
Okay, thank you. Next on my list I got is Member from Range Lake.
Thank you. So in your evaluation of this -- of extended health benefits, are you going to be speaking to beneficiaries who are now paying deductibles or more deductibles and engaging that feedback, I guess? Like, is there a client satisfaction survey that is going into this work, or are we just looking for a dollar by dollar analysis? Thank you.
Okay, thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, what I will say is that we are only halfway through this year from this -- when this change was I think -- believe September 3rd. So we will continue to -- I mean, we -- we will have the data, and once the year is up we will analyze the data, and we will look at -- like, I committed to providing to committee once we've analyzed the data on what's -- like, how the program was over the last year, you know, we'll provide that information to committee. Thank you.
Thank you. I'm going to go to the Member from Range Lake.
Thank you. Are you going to collect, like, the user experience or beneficiary experience as part of that data collection? That's what I'm looking for. Because, you know, we hear from constituents who are paying more now than they were before and, I mean, it sound great, right, that people have found new ways to lower their costs and accessing other benefits and everything's really working out really well, but I keep hearing from -- again, I have a constituent who texts me just about every month to remind me how much more he is paying, and that's -- that's -- and that's not the only information I get, Mr. Chair. So I'm just wondering are you capturing the experience of beneficiaries who are now experiencing those hardships? Just so we can get a sense of how clients are experiencing this. Thank you.
Okay, thank you. I'll go to the Minister. Thank you, Mr. Chair. Mr. Chair, I know that there has been -- I mean, the health admin office does deal directly with the clients and has been keeping, you know, the information that we will be needing to look at through this process. And once we get to the year and we analyze the data, we'll go forward on -- as to what further analysis that we need to do. Thank you, Mr. Chair.
Okay, thank you. I'm going to go to the Member from Range Lake.
Thank you. Do you know how much -- like, if you had maintained the old system but added the new client base, do you know what the cost for that -- the cost of the program would be? Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. No, because it's on a basis where people are utilizing supplies, they're utilizing medication, the cost of medication, you know, their prescription changes. They've left -- clients have left. New clients have come to the territories. People migrate from this program into the seniors' benefit program. So there's a lot of different moving pieces to this. So that is not something that we can say that we have offhand. Thank you.
Okay. Thank you. I'll go to the Member from Range Lake.
Thank you. No, that's fair. That's a difficult question to answer. Can the Minister remind me how many clients have fallen off? I know there's 366 new clients but how many have fallen off from previously registered? Thank you.
Okay, thank you. I'll go to the Minister.
Thank you. I think -- I believe of the 1200 people that were accessing benefits before, we have 794 and -- again, and 300 that were 429 of them on the last information I have were previous clients, and many -- like I said, before the program was is if you were a specific disease, you didn't even have to go through other insurances. And so now the program has been so that you're the user of last resort of the extended health benefits. So those that have previously been on them have been accessing, you know -- may have chosen to use their own insurance if they have work insurance and things like that if there were -- like, say, for instance, they work for the government, they will use their government insurance first. Thank you.
Thank you. I'll go to the Member from Range Lake.
Thank you. I guess I -- I wish that had kind of been explained ahead of time because it's a very reasonable idea that, like, the changes to the system are just using other insurance providers first and that would, I think, help sell this a lot more. But that being said, some people I know who work as public servants are still paying more. So public health care insurance plans don't cover everything, and there's still a need for these extended health benefits. What would it take for -- like, what kind of assessment would it take to lower the cost -- or to restore the benefits to the place they were? Because what I'm afraid of it is like last time, there was a fight over this and I, and other Members, were not happy with how this shook out. But the guarantee the Minister was like, don't worry, we'll look at it, and we'll come back and talk to you. But are you just -- is the Minister just going to come back and be, like, here are the numbers and we're going to continue? Because I think we're looking for a real, you know, give and take here. Like, is there a possibility that we can restore extended health benefits and take the edge off constituents who are paying more now than they were before? Thank you.
Okay, thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. I'm not sure if I understand the question. We still have -- everybody can still apply through extended health benefits. There are -- if they choose to -- you know, based on their income threshold and their net income, there has been things put in place where they can -- you know, instead of paying that lump sum right at the beginning, we made -- I've made an exception right off the bat that they could do it through monthly installments if they know -- like, some people, if they know that their prescriptions are -- and they're going to be utilizing this program, they can pay the deductible right off the bat, and they can do it over the year. So that was offered to anybody who provided that, and we have -- I think the last time we've -- I followed up on that that there was one person that was doing that. But that is an option and it is -- and then in the information that goes to the clients so that way if it is -- you know, to be able to come up with that full deductible right off the bat when they apply that they can break it down over the year. So thank you.
Thank you. I'll go to the Member from Range Lake.
Thank you. Well, I guess to be clear, so I have a constituent who is paying $4,000 more a year that he didn't before. So before the change to the program, he was paying zero dollars. Now he's paying $4,000. So how do we get to a point where he's back to zero? Thank you.
Okay, thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, based -- I mean, I'm not going to go into the details of the program here right now. I mean, I know that, as we said, we will be doing the review. Somebody who's paying $4,000 in a deductible is probably at the top end of the grid, and the bands were -- you know, I mean, I think the lowest band is $58,000 a year for, I think, band 10 that we talked about last year, and it's also based on how many people are in their household. You know, if there's -- if there's an adult. If there's children, then that's taken in account of what -- and it's based on their take home. It's not based on their gross; it's based on their take home. So that would be in one of the highest brackets I would say. Thank you, Mr. Chair.
Thank you. I'll go to the Member from Range Lake.
Yes, thank you. Well, I mean, I don't think we'll have a satisfactory answer here. What I'm looking at is, like, are we going -- is this going to be a negotiation or is this going to be an ongoing negotiation around, like, is this program working for our constituents, or is it going to be we've decided it is, here's the information, good bye, right? Like, I'm seeing if there's a willingness from the Minister to work to reconsider this decision. Because, again, I appreciate the challenges of health care sustainability and all that goes into that, but benefits to constituents that lower the cost of living in the Northwest Territories directly are really important, and I don't want to see them given up lightly, and I want to fight for this. So is the Minister willing to reconsider this after the review is done? Thank you.
Okay, thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, like I said in this House, I will wait until after we see the results of the first year of the review. We'll see, you know, the uptake. We'll be able to have the data. We'll be able to figure -- like, look at the difference of the clients that were on -- you know, that chose not to.
The thing is if they haven't applied and we don't know -- like, if they were in the old system of the -- and if they haven't applied, then we don't know what the difference is going to be so that kind of data, people didn't apply on the extended health benefits because they are in a higher tax bracket or, you know, then they -- we won't be able to analyze the data on how many people and what their costs were because that's also data that we will have to take in account. So I'm -- I'll just leave it at that, Mr. Chair.
Thank you. I'm going to go to the Member from Great Slave.
Thank you, Mr. Chair. So my questions to start are about medical travel benefits. I am looking here at the line item on page 218 of the mains, and I can see that the actuals in 2023-2024 were just below $30 million, and then the revised for 2024-2025 slightly over $24 million, and now we're estimating for 2025-2026 going ahead at $8.8 million. So my question is if this is another one of those items that we have a base amount and then we adjust as necessary, or are we restricting benefits? Thank you, Mr. Chair.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, if I can get the ADM can explain that. Thank you.
Thank you. I'll go to the ADM.
Thank you, Mr. Chair. So this one is a little bit of a varied answer. So in 2023-2024, we had an almost $30 million expense, and part of that was related to getting supplementary funding because our costs were higher. In 2024-2025 Main Estimates, the budget we have is $19 million. The revised main estimates show $24 million because it reflects $5 million that was added to the budget for federal funding. The territorial health investment fund allocates $5 million for medical travel. The change to 2025-2026 is because of the negotiations that the Minister spoke about with Indigenous Services Canada related to the non-insured health benefit and where we were able to negotiate additional funding into that agreement which allowed us the opportunity to move $15 million to address other pressures within the health care system. So that $15 million is now funded by third party, and the money is moved elsewhere in the budget for authority pressures that had been historically impacting their deficit. Thank you, Mr. Chair.
Thank you. I'll go to the Member from Great Slave.
Thank you, Mr. Chair. And thank you for that answer. I do have one more question about that line item. Can you please provide the rationale for the budget reallocations from medical travel funding to the health and social services authorities funding. Just curious how this will help with the administration of medical travel. Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, as I mentioned earlier that the reallocation of the medical travel funding at the NTHSSA to other pressure areas throughout their authorities is because we were able to get the funding through the NIHB agreement to actually pay for things that were for NIHB. We have been offsetting NIHB costs for many, many, many years, and so this last -- this last couple years, we were able to negotiate a special allotment fund to pay for a big portion of that, and so we were able to use -- because that's one of the things that was a deficit driver. When we got that additional funds from NIHB, we took the money that we had always allocated extra to pay for NIHB as a government, as GNWT, and then put that back into the health authorities where those pressures were historically happening in their system. Thank you.
Okay, thank you. I'm going to go to the Member from Great Slave.
Thanks, Mr. Chair. I guess I'm misunderstanding or misstating my question. The item on page 218 is listed as an HSS expenditure but then on page 219, it looks like it's shifting to the health authorities, so the -- to my mind, this $8.8 million is moving from the department to the authorities to deliver, or am I misunderstanding? Thank you.
Thank you. I'm going to go to the ADM.
Thank you, Mr. Chair. Yeah, so the money that's identified in the medical travel benefits line there, where it's the $8 million, it is money that's going to the health authorities for the -- to NTHSSA for the delivery of administration of medical travel. And if you look down below the line under expenditure category grants and contributions, you see the $8 million. That's reflective of the contribution that's going to the NTHSSA which is repeated, then, on page 219. It's the same. So the money is actually staying within the health authority within the NTHSSA. It's just being redirected from medical travel where it's no longer needed because ISC is now filling the gap to those other pressure areas in the authority where there had been historically deficits. Thank you, Mr. Chair.
Okay, thank you. Go back to the Member from Great Slave.
So the $8.8 million is going towards other deficits. What are we spending on medical travel? I'm lost in the sauce, Mr. Chair. Thanks.
Thank you. I'll go back to the ADM.
Thank you, Mr. Chair. The $8 million is going to medical travel. The $15 million, that's the difference between 2024-2025 and 2025-2026, has been shown elsewhere in the budget. And I can let you know about the things that those things moved to, which we've kind of already passed over, but there are things like leases, occupational health and safety positions, infection prevention and control positions, records management, some of the increase staffing in ICU and the emergency departments for Inuvik and Stanton. Those are things that have been, for a number of years, contributing to the historical deficit in the authorities which we've been monitoring, and so they were things that rose to the top when $15 million was identified and we were able to reallocate that funding over to those pressure areas. Thank you, Mr. Chair.
Thank you. I'll go back to the Member from Great Slave.
Thank you, Mr. Chair. And great, I'm so glad that you're able to relieve some of those pressures. My question specifically is the $8.8 million which is allocated from -- what I understand from HSS to the health authorities, that's always allocated that way? It was never administered by HSS; it's always been administered by the health authorities? Thank you.
Okay, thank you. I'll go to the Minister.
That is correct.
