QUESTION PERIOD — Ministry of Internal Trade
Health Care System
February 24, 2026
Thank you, minister, for being here.
Your 2025 CUSMA consultations confirmed a clear consensus among Canadians for a do-no-harm approach to the 2026 review. As you know, medicare is currently protected in CUSMA through reservations primarily found in Annex I and Annex II. However, while Reservation II-C-6 theoretically shields medicare, its public purpose clause is a known legal vulnerability if Canada expands or modernizes its public health offerings.
In light of these findings, how will your enforcement strategy specifically safeguard the autonomy of provincial health insurance plans against trade-based challenges? Will you commit to keeping Annex II protections — the protections for health and social services — off the table to ensure this remains a review and not a platform for eroding our sovereign right to deliver health care?
Senator, you just asked a fundamental question. I’m happy to commit that the government will, in those review discussions with our American friends, preserve precisely the exemptions that you identified.
This picks up on a question from your colleague. The Americans, in their conversations with us, are focused on a few sectors of the economy where the President is intent on enacting global tariffs as a pursuit of American policy to bring these manufacturing industries to the United States. That is properly the subject of American political discourse and debate.
In my conversations with the United States — with Secretary Lutnick and Ambassador Greer — they have not raised these issues with us in any way, nor would the Government of Canada in any way engage in renegotiating or weakening — and I’m not trying to parse words and be cute. It’s not something the Government of Canada would consider. But, to be very fair, it’s not something up to now that any of our partners in the trilateral agreement have raised with us.
Thank you, minister.
Alberta’s Bill 11 legislates a dual-track system that encourages private insurance coverage for medically necessary care. Legal experts warn this shift could weaken our Reservation II-C-6 protection, which requires health measures to be maintained for a public purpose.
In other words, by allowing physicians to bill both the public system and private patients concurrently, Alberta may be stripping these services of their public purpose status, potentially opening a back door for U.S. firms to demand market access under CUSMA’s national treatment obligations. During the upcoming review, what specific safeguards will you implement to ensure provincial privatization does not provide a loophole for the U.S. to challenge our medicare system?
Senator, thank you for that question. Right now is the first time I have heard the precision of drawing a connection between those lines, but the importance of protecting the Canadian public health care system from these theoretical or potential American trade actions is obviously of great importance. The good news is I’ll be back at the office when the Speaker releases me after 64 minutes — I thought it was 60 minutes. Once my time here has expired, senator, I would be happy to ask that exact question and share with you the answer.
