Summary#

This bill changes how provinces can take part in federal programs. It lets any province leave a federal program in a provincial area if the province runs its own program with similar goals. The province would still get the same federal money. It also exempts Quebec from the national rules tied to the Canada Health Transfer, so Quebec would receive the full transfer even if it does not meet those rules.

• Allows a province to withdraw from a federal program and still get the same funding if it has “comparable objectives” (Bill, FPFAA Part VI.1(1)-(2)).
• Exempts Quebec from Canada Health Act compliance rules for receiving the full cash transfer (Bill, CHA s.7(2)).
• States Quebec must receive the full Canada Health Transfer cash amount in section 5 of the Act (Bill, CHA s.7(2)).
• Creates an exemption for Quebec from paragraph 24(1)(a) of the Federal-Provincial Fiscal Arrangements Act (Bill, FPFAA s.24(2)).
• Does not set a process for deciding what counts as “comparable objectives” (Bill, FPFAA Part VI.1).

What it means for you#

• Households (Quebec)
  • No required change to your health coverage on the bill’s passage. The bill does not change Quebec laws or benefits (Bill, CHA s.7(2)).
  • Quebec would keep receiving full federal health funding even if it does not meet national criteria and conditions in the Canada Health Act (Bill, CHA s.7(2); CHA ss.8-12).
• Patients and health service users (Quebec)
  • Federal penalties for non-compliance with national health criteria would not apply to Quebec. This removes a federal lever that can reduce cash transfers over extra-billing or user charges (Bill, CHA s.7(2); CHA ss.18-20).
  • Any change to fees or access would still depend on Quebec’s own laws. The bill itself does not change those laws.
• Households and service users (other provinces)
  • No direct change to your health coverage. Other provinces remain subject to Canada Health Act criteria for full funding (CHA s.7(1)).
  • For other provincial areas (e.g., child care, housing, training), your province could choose to run its own program with similar goals and still receive federal funds. Services could be designed differently in your province if it withdraws (Bill, FPFAA Part VI.1).
• Workers and providers
  • Program rules may vary more by province where provinces withdraw and run their own comparable programs. Licensing, billing, reporting, or eligibility rules could differ by province (Bill, FPFAA Part VI.1).
• Provincial governments
  • New right to withdraw from a federal program in a provincial area while keeping the same federal contribution, if provincial program objectives are “comparable” (Bill, FPFAA Part VI.1(1)-(2)).
  • Quebec is exempt from Canada Health Act compliance requirements to receive full health funding (Bill, CHA s.7(2)).
  • The bill does not define who decides “comparable objectives,” what evidence is needed, or how disputes are resolved (Bill, FPFAA Part VI.1).
• Local governments and community agencies
  • If a province withdraws and redesigns programs, delivery terms and reporting lines may change. Funding amounts from Ottawa to the province would be unchanged under the bill’s “same contribution” rule (Bill, FPFAA Part VI.1(1)).

Expenses#

Estimated net cost: Data unavailable; the bill does not appropriate new funds and maintains existing transfer amounts.

• No official fiscal note identified. Data unavailable.
• Federal payments to a withdrawing province must equal what it would have received if it had stayed in the federal program (Bill, FPFAA Part VI.1(1)).
• Quebec must receive the full Canada Health Transfer cash contribution, regardless of compliance with national criteria (Bill, CHA s.7(2)).
• Potential fiscal effects could include foregone future deductions for non-compliance in Quebec under the Canada Health Act. Amounts are contingent and not stated. Data unavailable.
• Administrative costs to assess “comparable objectives” are not specified. Data unavailable.

Proponents' View#

• Respects provincial jurisdiction by letting provinces design programs that fit local needs while keeping their share of federal funds (Bill, FPFAA Part VI.1(1)-(2)).
• Provides stable and predictable health funding to Quebec by removing compliance-based deductions from the Canada Health Act (Bill, CHA s.7(2)).
• Does not increase total federal transfers relative to existing formulas; a withdrawing province receives the same contribution it would have received (Bill, FPFAA Part VI.1(1)).
• Encourages innovation by provinces through alternative program designs with similar objectives, without losing federal dollars (Bill, FPFAA Part VI.1).
• Reduces federal micromanagement and conditionality, which proponents say can slow or complicate program delivery (Bill, FPFAA Part VI.1).

Opponents' View#

• Weakens national health standards by guaranteeing Quebec full funding even if it does not meet Canada Health Act criteria tied to public administration, comprehensiveness, universality, portability, and accessibility (Bill, CHA s.7(2); CHA ss.8-12).
• Removes an enforcement tool (cash deductions) that protects patients from extra-billing and user charges in Quebec, reducing federal leverage to uphold patient protections (Bill, CHA s.7(2); CHA ss.18-20).
• “Comparable objectives” is undefined. This could trigger disputes or litigation over what qualifies, delay payments, and increase administrative burden (Bill, FPFAA Part VI.1).
• Could produce a patchwork of rules across provinces for major programs, creating uneven access and confusion for residents and providers (Bill, FPFAA Part VI.1).
• May reduce accountability for federal funds if provinces can opt out of conditions and still receive money, with fewer common reporting requirements. Data unavailable.