Alberta Premier Danielle Smith speaks to the media at a meeting of western premiers in Kananaskis, Alta., on May 25, 2026. The Canadian Press/Jeff McIntosh
Alberta Premier Danielle Smith says the federal government should respect the province’s jurisdiction over health care, after the federal health minister raised concerns about the legality of Alberta’s upcoming dual-practice health-care expansion.
“Let me be clear: the administration and delivery of health care is an area of provincial jurisdiction, not federal,” Smith said in a post on X
on Aug. 19.
“We expect the federal government to respect Alberta’s jurisdiction and its authority to determine how health care is delivered in this province.”
Alberta’s Health Statutes Amendment Act, 2025 (No. 2), also known as Bill 11, received royal assent in December 2025. The legislation establishes a framework for dual practice, allowing approved physicians to provide publicly insured services while also providing privately paid services, subject to provincial requirements. The model is set to roll out in September.
Health Minister Marjorie Michel had told the Toronto Star in an Aug. 16 report that she was “very concerned” about Alberta’s proposed system, and was concerned it could violate the “comprehensive” and “accessibility” aspects of the Canada Health Act.
The Canada Health Act requires provincial health insurance plans to cover all “insured health services” provided by hospitals and medical practitioners, as defined under the act. It also requires that insured persons have reasonable access to those services on uniform terms and conditions, without financial or other barriers.
Smith said Alberta’s dual-practice model does not violate the Canada Health Act and argued that the act does not prohibit private practice outside the publicly insured system.
“Albertans who choose to pay privately for eligible elective surgery should be able to do so here at home, rather than travelling out of province as they have done for decades,” she said.
“We remain committed to building a stronger public system and ensuring Albertans never have to pay out of pocket for medically necessary care – which is a commitment we have made under our Public Health Care Guarantee,” Smith said.
The Alberta government has argued dual practice will provide more “flexibility” and support “innovation” in the province’s health-care system. Alberta said the model could also ease pressure on the public health-care system by allowing other patients to move up the waitlist when some choose to access private care.
The government said no Albertans will be denied access to the health services they need if they are unable to pay, and that they will never have to pay out-of-pocket for medically necessary treatments.
