Alberta’s Bill 11 breaches the Canada Health Act, says legal expert
A 23-page legal opinion, prepared for the Canadian Health Coalition by Emma Phillips of Goldblatt Partners in Toronto, makes clear that Alberta’s Health Statutes Amendment Act, 2025 (No. 2), also known as Bill 11, brings in a new mix of public-private health care that flies right in the face of the requirements and principles of the Canada Health Act.
“We commissioned this legal opinion to make clear to all that the UCP government is violating the Canada Health Act,” says Canadian Health Coalition Chair Jason MacLean.
“We know that the Alberta government is working with the private insurance companies, and keen to tear down public programs to give their friends in private health care even more money. We want the federal government to put a stop to this and use its powers to protect universal public health care,” says MacLean.
- Read Jason MacLean’s and Emma Phillips’ op-ed in The Hill Times here.
- Watch an interview with Emma Phillips on CTV.
Phillips, a leading practitioner in labour and employment law, concluded Alberta breaches federal legislation “by explicitly enabling differential access to medically necessary care based on ability to pay in the private market.”
Read the full legal opinion here. Read the summary here.
Bill 11 was passed December 18, 2025, making Alberta the only province that allows physicians to work simultaneously in the public and private health care systems, surpassing the privatization of physician services in Québec, where physicians have to wait before changing from private to public and cannot do both at the same time.
Phillips says Alberta’s law contravenes multiple conditions of the Canada Health Act, which provinces must fulfill to be eligible for the Canada Health Transfer, federal cash transfer payments.
According to an investigation by the CBC and Humber College StoryLab in 2023, federal health transfers amounted to $47.1 billion, a 212 per cent increase over 2005, when the transfers were $15.1 billion. Total spending by all 10 provinces grew in that time to $221.9 billion up from $86.2 billion, an increase of 158 per cent.
For the 2026–2027 fiscal year, the federal government is providing Alberta with $7.04 billion through the Canada Health Transfer (CHT).
These payments should be reduced, she said, if Alberta forges ahead as planned.
CHT funds have at times been withheld for violations of the Canada Health Act in relation to extra billing and user charges. Health Canada produces an Annual Report on the extent to which provincial and territorial health care insurance plans have satisfied the criteria and the conditions for payment under the Act.
The Canadian Health Coalition will host a webinar on the Annual Report of Health Canada featuring health policy experts from the Health Canada Health Act Division on June 30, 2026. You can tune in here.
“Alberta’s Bill 11, I think, very clearly violates both the letter and the spirit of the Canada Health Act,” Phillips told The Globe and Mail.
The Act stipulates that all medically required services are publicly insured (Section 9), there is “reasonable access” to insured services without financial barriers (Section 12) and people are entitled to them on “uniform terms and conditions” (Section 10).
Phillips says Bill 11 violates prohibitions against user fees and extra billing (sections 18 and 19), which protect patients against out-of-pocket charges for services that are covered by provincial health plans.
The federal government has taken the position since 1984, when the Act came into effect, that medically necessary services must be provided on the basis of need, not the ability to pay.
Ottawa argued in the Cambie case that two tier or “dual practice” creates “queue jumping” and shifts physicians and other resources out of the public sector.
Critics of Bill 11, including the Canadian Doctors for Medicare and the Canadian Medical Association argue it will incentivize physicians to move patients into the private sphere, lengthening n public wait times, and could result in poor health outcomes for those who cannot afford to pay out of pocket.
Premier Danielle Smith’s government argues that Bill 11 will decrease wait-lists for surgeries and attract more physicians to the province. Alberta has said safeguards will be in place, such as requiring a minimum number of hours worked in the public system.
But any safeguards are “no response to the explicit failure of the dual practice provisions, on their face, to respect the requirements and protections of the Canada Health Act,” Phillips argued in the opinion dated April 30.
The UCP approach has come up before. In 2015, an Alberta court struck down another challenge that attempted to overturn the province’s ban on private health insurance. The Allen v. Alberta case recognized “dual practice is inconsistent with the requirements and criteria of the Canada Health Act,” Phillips said, adding that it underlines her conclusion about Bill 11.
The Canadian Health Coalition, who commissioned the legal opinion, hopes the new opinion pushes the federal government to take a firm position and defend universal health coverage in Canada.
“If there are no financial consequences for Alberta, the business and financial pressures on other governments to follow suit is going to be very hard to resist,” Phillips said.
