Bill 20 was adopted at the National Assembly Tuesday after the health minister was forced to make some compromises.

Despite strong opposition to the controversial health care bill, with a Liberal majority, the adoption of this bill is no surprise. The final count was 63 votes for and 48 against.

Liberal MNAs stood and clapped for Health Minister Gaetan Barrette when the bill was adopted.

Before it passed, however, one last battle took place in the Blue Room at the National Assembly.

“This way of doing things may contribute to the emergence of a two-tier system,” by allowing doctors to charge ‘accessory fees’ for some services at private clinics,said PQ leader Pierre Karl Peladeau.

Barrette, however, said Bill 20 creates a framework with clear guidelines that actually protect patients from excessive fees.

“No additional fees, no illegal fees, and if there are fees billed to the patients, it will be significantly less than what it is today,” he said.

The new legislation also means changes to the province's publicly-funded in-vitro program.

Quebec has backed away from its original plan to make it illegal for women over the age of 42 to pursue IVF, but the province won't be paying for it anymore. Instead, eligible families will receive a tax credit that depends on their income.

Initially, Bill 20 would have also forced penalties on family doctors if they didn't meet a patient quota, but Barrette backtracked on that proposal after a backlash from the Quebec Federation of General Practitioners.

The compromise is that the plan is off the table for two years – if GPs make sure 85 per cent of Quebecers have a family doctor by the end of 2017.