The law creates a two-tier health care system for Albertans, and undermines Canada’s universal public system
OTTAWA — Legal experts in the health care field have completed a thorough examination of Alberta Premier Danielle Smith’s Bill 11 health care law and found it to be in clear violation of the federal Canada Health Act.
Bill 11 is, “the most extensive privatization of payment for medically necessary services in Canada since the Canada Health Act was enacted in 1984,” writes Emma Phillips of Goldblatt Partners LLP.
“The Canada Health Act embodies the fundamental value that medical services should be allocated on the basis of need, not ability to pay,” she writes. “Facilitating a two-tier regime introducing private payment for medically required services which in turn can lead to preferential access is directly contrary to the core requirements, criteria and principles of the Canada Health Act.”
On December 18, 2025, Alberta enacted the Health Statutes Amendment Act, 2025 (No. 2), also known as ‘Bill 11’. Bill 11 amends the Alberta Health Care Insurance Act by establishing the legal framework for physicians to engage in dual practice.
“Albertans I’ve talked to are very concerned that some patients will be able to access medically necessary services more quickly based solely on their ability to pay,” said Chris Gallaway, executive director of Friends of Medicare. “Bill 11 is entrenching legislated ‘queue-jumping.’ And we now have legal experts confirming that it contravenes the principles of comprehensiveness, accessibility, and universality protected and required by the Canada Health Act and violates the prohibitions against extra-billing and user fees. It cannot be allowed.”
“The federal government is balancing diplomatic engagement with Alberta against the need to enforce CHA principles firmly,” said Jason MacLean, chairperson of the Canadian Health Coalition which commissioned Goldblatt Partners LLP to conduct the review.
“Health Minister Marjorie Michel often says she is the ‘Guardian of the Canada Health Act,’” said MacLean. “The Minister needs to clarify that it is the federal government’s position that Alberta’s Bill 11 violates the Canada Health Act, and she is prepared to enforce the Act.”
The Province of Alberta could be jeopardizing over $7 billion through the Canada Health Transfer in 2026-2027. The Canada Health Act empowers the federal government to withhold transfers should the province fail to comply with the Act.
Read the summary of the opinion, or watch the recording of today's press conference.
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